IOWA Medicaid and CHIP (Hawki)
NEW JERSEY Medicaid and CHIP
Medicaid Website: https://dhs.iowa.gov/ ime/members Medicaid Phone: 1-800-338- 8366 Hawki Website: http://dhs.iowa.gov/ Hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://dhs.iowa.gov/ime/
Medicaid Website: http://www.state.nj.us/ humanservices/ dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/ index.html CHIP Phone: 1-800-701-0710
members/medicaid-a- to-z/hipp HIPP Phone: 1-888-346-9562
INDIANA Medicaid
NEW YORK Medicaid
Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone 1-800-457-4584 MASSACHUSETTS Medicaid and CHIP Website: https://www.mass.gov/info-details/ masshealth- premium-assistance-pa Phone: 1-800-862-4840
Website: https://www.health.ny.gov/health_ care/medicaid/ Phone: 1-800-541-2831
PENNSYLVANIA Medicaid
Website: https://www.dhs.pa.gov/providers/ Providers/Pages/Medical/HI PP-Program. aspx Phone: 1-800-692-7462
To see if any other states have added a premium assistance program since July 31, 2021, or for more information on special enrollment rights, contact either:
U.S. Department of Labor Employee Benefits Security Administration
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565
www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272)
OMB Control Number 1210-0137 (expires 1/31/2023)
EFFECTIVE DATE OF THIS NOTICE
This Notice is effective as of January 1, 2022.
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