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FAQs: Eligibility and enrollment Q. What happens when I am eligible for the OHP Standard benefit package but have access to employer-sponsored health insurance? A. You must tell us if you have access to employer-sponsored insurance when you apply or reapply for OHP Standard. You must also tell your worker if it becomes available after you become eligible for OHP Standard. If you do have access to employer-sponsored insurance, your employer must fill out the Group Insurance Information form. Your DHS worker will send the form to FHIAP. An FHIAP worker will decide if you are eligible for help from FHIAP. If you are eligible, you will be required to enroll in your employer's health insurance plan. FHIAP will pay a large portion of the premium costs. You will be responsible for copayments, co-insurance and deductibles. Your OHP Standard coverage will end when your employer coverage begins. Some members of your household may qualify for the OHP Plus benefit package. We allow them to choose between FHIAP and OHP Plus benefits. Back to top Q. What happens if I am getting the OHP Standard benefit package and I am found eligible for help from FHIAP but my employer-sponsored health insurance plan in closed to new enrollment? A. In this case, you can keep your OHP Standard coverage until the employer plan opens its enrollment. Your OHP coverage will end on the day before your FHIAP benefits start. This situation might not happen. Most insurance companies let FHIAP applicants enroll without waiting for the next open enrollment period. Back to top Q. Can I choose to leave FHIAP and move into OHP? A. You cannot receive FHIAP and OHP benefits in the same month. However, as an FHIAP client, you can apply for OHP at any time. If you qualify for OHP, FHIAP will end your benefits. It is important that you do not stop your health coverage under your employer's plan before you apply for OHP. If you stop your health coverage before you apply but do not qualify for OHP, you will not qualify for FHIAP again for six months. Back to top Q. What happens if I lose a job that provides health insurance for which I receive an FHIAP subsidy? A. If you lose your job, you will lose employer-sponsored health insurance. You will have other coverage options. These include COBRA, Portability or State Continuation. FHIAP will subsidize whatever option you select. You may also apply for coverage under OHP. Back to top Q. What happens when my benefit package changes because of a change in eligibility? A. For OHP, you will get a new OMAP Medical Care Identification. It will show the correct benefit package for each member of your household. It will also show the required copayments, if any, for each person. If any members of your household are covered by FHIAP, they will get a Medical ID card from their private health plan. Back to top Q. How long will OHP or FHIAP coverage last before I need to reapply? A. For OHP, you must reapply after six months. An OHP application will be mailed to you at the end of the fifth month of coverage. For FHIAP, you must reapply after twelve months. An application will be mailed to you at least 60 days before your FHIAP subsidy ends. Back to top |
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