Follow. Robin Rudowitz A smaller number of states with existing waivers that cover adults are not moving forward with the ACA Medicaid expansion and their waivers are set to expire beginning January 1, 2014. Make sure you keep paying your POWER Account contributions to keep HIP Plus benefits. You receive this handbook when you become a MDwise member. If you want to know about a specific service that is not listed, please call MDwise customer service and we will research it for you. Offering you gifts or money to receive treatment or services. Beginning in January 2008, Indiana began enrolling adults in its new Healthy Indiana Plan (HIP), which was authorized under Section 1115 waiver demonstration authority. Download the free version of Adobe Reader. Ensure state fiscal responsibility and efficient management of the program. Learn more about the formula shortage and how to keep your baby safe and healthy during this time. Go to FSSABenefits.IN.gov to update your information so you dont lose benefits. Eligibility and Enrollment Under the Waiver Extension. For example if your POWER account contribution is $4, then your first two months of coverage will be paid in full, you will owe a balance of $2 in the third month, and then $4 for every following month to maintain HIP Plus enrollment. , and Medical and dental services covered by MDwise. If they receive recommended preventive care services throughout the year, the discount will be doubled. Welcome to the MDwise Healthy Indiana Plan (HIP). Of HIP enrollees not contributing to their accounts, about 13% were parents with no income or already contributing at least 5% of their family income to their childs CHIP coverage. Click here to access a calculator that will help you determine if you are eligible for HIP and will estimate your monthly POWER account contribution. Once a member is approved for HIP, he or she will be assigned to the health plan selected on the application. Alexandra Gates , Some members can have HIP Basic coverage even if they dont make their monthly payment, but in HIP Basic they will have to pay a fee every time they go to the doctor or fill a prescription. Telling us about your other insurance will not reduce your MDwise benefits. Copayments for non-preferred drugs are $8. As long as members make their required monthly POWER account contributions, they will have no other costs. Click hereto learn how you can earn My Health Pays rewards. The one year extension of HIP preserves coverage for the parents and other adults currently covered by the program. Copayments for preferred drugs are $4. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. In HIP, your contributions to your POWER account will be yours. If a health care provider makes a Fast Track payment for you, the provider should ask you to complete a form that gives them permission to make this payment (PDF). Only those individuals who may be eligible for HIP will receive a Fast Track invoice. Once an individual selects or is assigned to a plan and makes an initial POWER Account payment, the enrollee must remain in that plan for 12 months.13 Currently, there are three managed care plans from which most enrollees chooseAnthem Blue Cross and Blue Shield (62% of the enrollees), MDWise with AmeriChoice (24%), and Managed Health Services (MHS) (9%).14 Enrollees who have an identified high-risk condition (e.g., cancer, organ transplant recipient, HIV/AIDS) receive benefits through the Enhanced Services Plan (ESP) (4% of enrollees), which is a fee-for-service inpatient health plan that also manages the states high risk pool. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare. If you move or change your phone number, you must let the Division of Family Resources (DFR) know. HIP Plus members receive more visits for physical, speech and occupational therapists than the HIP Basic program, and coverage for additional services like bariatric surgery and Temporomandibular Joint Disorders (TMJ) treatments is included. Healthy Indiana Plan (HIP) also rewards members for taking better care of their health. John Holahan, Matthew Buettgens, and Stan Dorn. We will call you back to let you know the estimated reimbursement for that service. But HIP means more than just coverage. You can also call MDwise Customer Service at 1-800-356-1204, Monday through Friday, 8 a.m. to 8 p.m. Kaiser Commission on Medicaid and the Uninsured, A Look at Section 1115 Medicaid Demonstration Waivers Under the ACA: A Focus on Childless Adults. To participate in HIP Plus, members make affordable monthly contributions into their POWER account based on income. Billing or charging for a treatment, service or supply that is different than what you received. This means you won't have to pay when you visit the doctor, fill prescriptions or stay in the hospital. Healthy Indiana Plan and the Affordable Care Act, http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/in/in-healthy-indiana-plan-ca.pdf, http://www.in.gov/fssa/hip/files/April122013HIPWaiverExtensionApp.pdf, http://publications.milliman.com/research/health-rr/pdfs/experience-under-healthy-indiana.pdf, http://www.in.gov/fssa/files/Presentation_to_Health_Study_Committee_Final_7_13_10.pdf, http://www.mathematica-mpr.org/publications/PDFs/health/healthyindianaplan_ib1.pdf, http://www.kff.org/medicaid/issue-brief/a-look-at-section-1115-medicaid-demonstration-waivers-under-the-aca-a-focus-on-childless-adults/, https://www.kff.org/wp-content/uploads/2013/10/8505-the-coverage-gap-uninsured-poor-adults7.pdf, http://www.kff.org/medicaid/report/the-cost-of-not-expanding-medicaid/, Status of State Action on the Medicaid Expansion Decision, Analyzing the Impact of State Medicaid Expansion Decisions, Getting into Gear for 2014: Shifting New Medicaid Eligibility and Enrollment Policies into Drive. Hip dysplasia - Symptoms and causes - Mayo Clinic If you make a Fast Track payment and are eligible for HIP, your HIP Plus coverage will begin the first of the month in which you made your Fast Track payment. Enhanced benefits are available to individuals whose health status qualifies them as medically frail. You can also visit the Indiana Department of Health for more information or to schedule your COVID-19 vaccination. HIP Basic is the plan for HIP members who do not make their monthly Personal Wellness andResponsibility(POWER) Account contributionsfor more than60 days.HIP Basic . Two-thirds of those enrollees were childless adults and the remaining third were parents (Figure 1).2, Figure 1: HIP Enrollment of Parents with Dependent Children and Other Adults, 2008 -2012. Kaiser Commission on Medicaid and the Uninsured, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, October 2013), https://www.kff.org/wp-content/uploads/2013/10/8505-the-coverage-gap-uninsured-poor-adults7.pdf. Reduce the number of uninsured residents in the state; Improve statewide access to health care services for low-income residents; Promote value-based decision making and personal responsibility; Prevent chronic disease progression with secondary prevention (treatment, prescriptions); Provide appropriate, and quality or evidence-based, health care services; and. Patient information: Hip pain (Beyond the Basics). As approved in 2008, HIP expanded coverage to parents with dependent children with incomes above the states eligibility limit for full Medicaid coverage (22% FPL) and below 200% FPL and other adults with incomes between 0% and 200% FPL. You could also qualify for an additional $85 dollars of My Health Pays rewards. Fast Track is a payment option that allows eligible Hoosiers to expedite the start of their coverage in the HIP Plus program. You are in the MDwise health plan. Do not give your member ID card or MDwise card number to anyone. Hip pain - Mayo Clinic Members will have 60 days to make their POWER account contribution from the start of the HIP Basic benefits. As of December 2012, there were only 13,225 childless adults enrolled in HIP, accounting for only a third of enrollment allowed under its current cap of 36,500 and an additional 46,388 adults remain on the waitlist for coverage.3 In contrast, parent enrollment increased between 2008 and 2012, from about 12,000 parents to over 25,000. MDwise Hoosier Healthwise members can call 1-844-336-2677 to ask about medicines that are covered. If you wait more than 60 days to make a payment and your income is more than the federal poverty level, then your application will be denied and you will have to reapply for HIP coverage. You can make a Fast Track payment by credit card when you apply online or, after applying, while your application is being processed. HIP Plus provides health coverage for a low, predictable monthly cost. Since you do not make a monthly contribution for HIP Basic services there will be a payment required for most health services including seeing a doctor, filling a prescription or staying at the hospital. You must also tell us (or your care manager) if: The other insurance plans are supposed to help pay for your care. What's the difference between HIP Basic and HIP Plus? This brief provides an overview of HIP and the implications of the waiver extension and Indianas decision to not implement the ACA Medicaid expansion. Advertising revenue supports our not-for-profit mission. Hoosier Healthwise (HHW) is one of the Indiana Medicaid programs. HIP Plus provides MORE benefits than the HIP Basic program, including vision, dental and chiropractic services. Were here to help you with the latest information about your benefits, getting care and finding local help and resources. You can pay your Fast Track invoice or POWER account contribution to your new health plan and your coverage will start the month in which your payment is received and processed. The state of Indiana pays for most of the $2,500 in the POWER account, but the member is responsible for a fixed monthly payment depending on income. How HIP Basic works Copays Find a doctor, hospital, pharmacy or specialist that serves your plan. McLaren Health Care and/or its related entity, Commitment to Quality Care | Healthy Indiana Plan, Find a Drug | Healthy Indiana Plan State Plans, Benefits and Services | Hoosier Healthwise, Affordable Connectivity Program | Hoosier Healthwise, Commitment to Quality Care | Hoosier Healthwise, Getting Help with a Problem | Hoosier Healthwise, Renewing Your Coverage | Hoosier Healthwise, Nondiscrimination/Accessibility (English), Nondiscrimination/Accessibility (Spanish).
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