This post is part of an ongoing series called Little Known Medicaid Benefits. The series explains types of uncommon benefits, including eligibility requirements and how to help clients apply. This edition focuses on the Colorado Health Insurance Buy-In program.
Other topics in the series include:
What you should know about HIBI:
The Colorado Health Insurance Buy-In (HIBI) is Health First Colorado (Colorado’s Medicaid Program) program that helps Health First Colorado members pay for monthly commercial health insurance premiums. Commercial health insurance includes employer sponsored insurance, self-funded insurance, or COBRA. Connect for Health Colorado plans with tax credits or cost sharing reductions do not qualify for HIBI. HIBI only covers premiums for the eligible member and does not include other family members who are not eligible for HIBI or Health First Colorado. Health First Colorado Buy-in and Child Health Plan Plus members are not eligible for HIBI either.
HIBI is a relatively small program, with approximately 790 members.
HIBI eligibility requirements:
To be eligible for HIBI, someone must be eligible and enrolled in Health First Colorado and have access to or be enrolled in commercial health insurance. The member’s health insurance must also be considered cost-effective by HCPF. A health insurance plan is cost-effective when the annual cost of the insurance premiums is less than the annual amount that Health First Colorado would pay for the member’s medical services. Often if a member has high-cost medical needs, such as pregnancy support or cancer treatment, the cost of their premiums is less than the care they would need in that year, which would make them eligible.
HIBI members continue to receive Health First Colorado benefits in addition to benefits from their commercial health insurance. This is especially helpful when a member cannot access specialty services or needs wider network of doctors than are covered by Health First Colorado or available in their region. In addition to covering monthly health insurance premiums, HIBI sometimes reimburses for deductibles, coinsurance, and co-pays.
Application information to share with your clients:
- Refer a Health First Colorado member to HIBI if they can answer yes to the following questions:
- Are you or a member of your family a Health First Colorado member?
- Do you or a Health First Colorado member in your family have access to commercial health insurance through private insurance, employer-sponsored insurance, or COBRA, or are you already enrolled?
- Do you have specialty health care needs?
- HIBI does not have an open enrollment period.
- Applying and being eligible for HIBI is considered a qualifying life change event, so members can enroll in a commercial health insurance plan within 60 days of being notified of their HIBI eligibility, even if this is outside of the (or an employers’) regular open enrollment period.
- Applicants should apply online at https://www.mycohibi.com/apply/ or by completing the paper HIBI application and sending it by mail to 1550 Larimer St. Box #1000, Denver, CO 80202 or fax to (855)226-4424.
- Applicants must also submit:
- A copy of the front and back of their insurance card
- Summary of benefits for the health insurance plan and premium rate sheet
- A recent paystub or other verification to show proof of the premium payment
- Applications take 30-days to be processed from the date the application and supporting documents are received.
More information is available from HCPF and the HIBI website.
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