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FAQs About HIPP

FAQ

Below are the questions that dialysis patients and renal care professionals most frequently ask about the American Kidney Fund's Health Insurance Premium Program (HIPP). Click on any of the questions to read the response.

If you have questions that are not shown below, please call the American Kidney Fund's Patient Services Department at 1-800-638-8299, or send an e-mail.

Q: What types of insurance policies are paid for by HIPP?

A: HIPP pays premiums for Medicare Part B, COBRA, Medigap and commercial policies.

Q: How can a patient receive assistance from HIPP?

A: The patient should speak with the social worker at the dialysis facility. The social worker can work with the patient to submit an application. Strict eligibility guidelines apply; click here for details. The American Kidney Fund does not accept HIPP applications directly from patients.

Q: I had a kidney transplant. Why am I not eligible for HIPP assistance?

A:  The HIPP program is for dialysis patients only because we do not have underwriting available from other sources to support coverage for transplant patients. HIPP currently serves more than 33,000 dialysis patients nationwide on an ongoing basis. The program is 100% funded by provider contributions.

Q: What happens if I have a transplant while I am enrolled in HIPP?

A: Dialysis patients enrolled in HIPP are not eligible to continue receiving assistance once transplanted.  HIPP will provide assistance for one month post-transplant, if the payment has not already been made. 

Q: My records show that AKF made a payment for my patient, but the insurance company has no record of it. What should I do?

A: Insurance companies sometimes cash the premium checks through their lock boxes, but for various reasons are unable to properly credit the patient’s policy. Contact our Patient Services department at 800-638-8299 to find out if the check has been cashed. If it has, a copy of the cancelled check can be provided for you to give to the insurance company. If it has not, a reissue can be requested if the check is over 45 days old. You should also verify the mailing address.

Q: Does the American Kidney Fund prioritize premium requests by their due date?

A:  According to the federal Advisory Opinion (97-1) which allows the American Kidney Fund to operate the HIPP program, the American Kidney Fund is obliged to handle premium requests on a first-come, first-served basis. We will do our very best to pay urgent requests if they are submitted by noon on Tuesdays, but we make no guarantees. Your best assurance of timely payment is timely submission. The American Kidney Fund begins accepting premium requests 45 days in advance of the beginning of each quarter (see quarterly payment schedule on HIPP Guidelines Procedures sheet).  In addition, the American Kidney Fund strongly recommends that you submit your premium requests early and that you prioritize them according to their time-sensitivity. COBRA policies are most time-sensitive; if you have a choice, submit them first.  Generally speaking, Medigap premiums are less time sensitive than COBRAs, and Medicare premiums are the least time-sensitive.

Q: Why does the American Kidney Fund generally pay only one quarter at a time?

A:  There are several reasons.  First, the contributions necessary to fund premium payments are made on a quarterly basis.  Second, most insurance companies discourage premium payments for future quarters and many will refund advance payments to your patients.  And, third, should your patient transfer, receive a transplant, or pass away, there will be a larger refund at risk for retrieval.

Q: Why won’t HIPP pay for tertiary coverage, if the patient is eligible for Medicaid?

A:  AKF will not pay for duplicative tertiary coverage.  HIPP’s purpose is to ensure that eligible dialysis patients have a mechanism for paying for their dialysis treatment.  Eligibility for Medicaid usually means that patients have a mechanism for paying the Medicare allowable balance due of 20% when Medicare is their primary insurer.  In circumstances where this is not the case, AKF will request additional documentation to explain a patient’s individual Medicaid benefits.

Q: Why doesn’t the American Kidney Fund reimburse patients who have their health insurance premiums deducted from Social Security checks? 

A: HIPP is not an insurance premium reimbursement program.  Eligibility is restricted to financially qualified patients who have no alternative means for paying their health insurance premiums and who would not have Medicare coverage without the benefit of HIPP.  Individuals whose Medicare premiums are deducted automatically from their Social Security checks have a mechanism for guaranteeing premium payment.

Q: Who are HIPP liaisons and what is their role?

A: HIPP liaisons are employees of corporate and some independent dialysis providers.  They coordinate HIPP communication between their company’s social workers and the American Kidney Fund.  HIPP liaisons track the progress of each patient’s grant request from the time it is submitted to the American Kidney Fund to the time a grant payment is issued so that patients and their social workers are kept informed.  They also help educate social workers about the HIPP program and troubleshoot problems that arise.

Q: What happens if the HIPP funding pool is depleted?

A: AKF sends an urgent message to all of its HIPP contributors when funds are low, but continues to process requests.  Checks are issued as soon as the funding pool is replenished. 

Q: Where can I read about the American Kidney Fund’s OIG Opinion regarding the administration of HIPP?

A: A copy of Advisory Opinion No. 97-1 can be obtained at www.complianceland.com 


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