Common use of HIP Plus Clause in Contracts

HIP Plus. Except in the case of individuals eligible for HIP State Plan benefits described in Section 3.3 or individuals receiving hospital presumptive eligibility benefits described in Section 3.5, all HIP eligible members will initially be defaulted into an enhanced benefit package (HIP Plus). Except for individuals exempt from copayments as set forth in Section 4.1.4, HIP Plus participation requires members to make monthly POWER Account contributions. Member eligibility in HIP Plus shall not be final until either the first POWER Account contribution or fast track prepayment contribution is paid, in accordance with Section 4.7. Except as set forth in Section 4.7.1, to remain eligible for HIP Plus, members shall continually make monthly POWER Account contributions as set forth in Section 4.1.1. 3.1.1 Low Income Adults Parent/caretaker members determined eligible for transitional medical assistance (TMA) by the State in accordance with Section 1925 of the Social Security Act shall either attain or remain in HIP Plus coverage for up to twelve (12) months during their TMA eligibility period. If after the first six (6) months of TMA coverage income remains over 138% but below 185% FPL, coverage can extend an additional six (6) months as long as POWER Account contributions are paid. The State will identify all members eligible for HIP Plus benefits that meet the eligibility criteria of this Section 3.1.1.