Healthy Indiana Plan (HIP)

The Healthy Indiana Plan now makes coverage available to hundreds of thousands of Hoosiers who did not have an insurance option before. But HIP means more than just coverage. With HIP Plus, eligible Hoosiers can have better benefits and predictable monthly costs, and can be enrolled in coverage faster. Here’s how:

HIP Plus is the best value plan that includes, dental, vision and chiropractic services and has no copayments except for non-emergency use of the emergency room. To enroll in HIP Plus, eligible individuals must make a monthly contribution to their POWER Account to help cover initial health expenses. Individuals with family income at or below the federal poverty level will default to HIP Basic if they do not make their POWER Account contribution. HIP Basic does not cover dental, vision or chiropractic services and charges a copayment for each service received. HIP Basic can be more expensive that HIP Plus.

HIP Plus coverage begins the first of the month in which an individual makes their POWER account contribution or makes a $10 “Fast Track” payment.

What is Fast Track?

Fast Track is a payment option that allows eligible Hoosiers to expedite the start of their coverage in the HIP Plus program. Fast Track allows you to make a $10 payment while your application is being processed. The $10 payment goes toward your first POWER account contribution. 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.

What happens if I don’t make a Fast Track payment?

If you do not make a Fast Track payment, you may face a delay in the start of your coverage. For example, if you apply June 5 and receive a $10 Fast Track invoice on June 12, your HIP Plus coverage could be effective beginning June 1 – if you make your $10 payment in June. From the date the invoice is issued, you have 60 days to make either a Fast Track payment or your first POWER account contribution to be able to begin HIP Plus coverage . If you make your Fast Track payment or first POWER account contribution in July then your HIP Plus coverage will begin July 1. If you make the contribution in August, you will begin HIP Plus August 1. If your 60 days to pay expires in August without you making either a Fast Track payment or POWER account contribution, then you would default to HIP Basic coverage effective August 1 if your income is below the federal poverty level.

Unlike HIP Plus, HIP Basic does not cover dental, vision or chiropractic services. 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. If your income is more than this amount, you will need to reapply for coverage to begin HIP.

How do I make a Fast Track payment?

You can make a Fast Track payment by credit card when you apply online or, after applying, while your application is being processed. Fast Track payments are made to the Managed Care Entity (MCE) or health plan, you select on your application to provide your HIP coverage (Anthem, Caresource, MDwise or MHS). After making the payment you may not change your MCE/health plan, so be sure you select the right one for you. For help making your selection, call 1-877-GET-HIP-9.

Payments made with the online application

Anyone who applies for Indiana Health Coverage Programs online will have the opportunity to make a Fast Track payment by credit card when completing the application. You must select a Managed Care Entity in order to make a payment at the time of application. If you make a Fast Track payment and are determined to be eligible for HIP then your HIP Plus coverage will begin the first of the month that you submitted your application.

Payments made while your application is being processed

If you do not apply online, or choose not to make a Fast Track payment when you apply, you will still have the opportunity to make a Fast Track payment while your application is being processed. You will receive a Fast Track invoice from the Managed Care Entity (MCE) you selected to provide your health coverage. If you did not select an MCE you will be automatically assigned to one. If you pay the Fast Track invoice and are determined to be eligible for HIP then your HIP Plus coverage will begin the first of the month that your payment was received and processed.

What if my POWER account contribution is not $10?

If you are found eligible for HIP and you make your $10 Fast Track payment, this payment will be applied toward your POWER account contribution(s). Your monthly POWER Account contribution will be based on your income. This may be more or less than $10 per month. If your POWER account contribution amount is less than $10 per month, your $10 payment will be applied to your initial coverage month with the remaining amount applied to future months.

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. If your POWER account contribution is more than $10, then you will owe the balance in the first coverage month. For example if your POWER account is $15, then your $10 payment will be applied to your first month’s coverage. You will owe an additional $5 for that month of coverage and $15 for each following month.

What if I am not eligible for HIP?

You are offered the opportunity to make a Fast Track payment before you have been found eligible for HIP. If you are not found eligible for HIP and you have made a Fast Track payment, this payment will be refunded to you by the MCE (Anthem, Caresource, MDwise or MHS) that took the payment.

Do I have to make a Fast Track payment?

While making a Fast Track payment can help ensure you get enrolled in HIP Plus as quickly as possible, you are NOT required to make a Fast Track payment. From the date you receive your initial Fast Track invoice you will have 60 days to make a payment to start your HIP Plus coverage. You can pay either the $10 Fast Track payment or your POWER account contribution amount. If you do not make your contribution or Fast Track payment within 60 days and your income is less than the federal poverty level you will be enrolled in HIP Basic where you will have copayments for all services and you will not have dental, vision or chiropractic. 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.

Can someone make my Fast Track payment for me?

Yes. You may have someone make your Fast Track payment on your behalf. However, as is the policy with all HIP payments, once a payment is made (whether you or someone else pays it), you will not be able to change your MCE/health plan. 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). 

If you need help picking the right health plan for you, call 1-877-GET-HIP-9.

Once I make a Fast Track payment, can I change my MCE/health plan?

No. Once you pay your Fast Track invoice you may not change your MCE/health plan. You may change your health plan selection before paying your Fast Track invoice by calling 1-877-GET-HIP-9. 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. Only make a payment to the health plan that you want to be your HIP coverage provider. You will not have the opportunity to change your health plan until Health Plan Selection in the fall.

What if I didn’t get a Fast Track invoice?

Only those individuals who may be eligible for HIP will receive a Fast Track invoice. If you applied and did not receive a Fast Track invoice it could be because you are eligible for another coverage program – such as if you indicated that you are pregnant, disabled, a former foster care child or on Medicare when you applied. If you are ultimately found eligible for HIP, you will receive an invoice for your POWER account contribution, and your coverage will be effective the first of the month in which your initial POWER account contribution is received and processed.

HIP Plus provides the best value coverage and includes dental, vision and chiropractic services. HIP Plus provides health coverage for a low, predictable monthly cost. Members pay affordable monthly contributions, and the only other cost for health care in HIP Plus is a payment of $8 if you visit the emergency room when you don’t have an emergency health condition. HIP Plus can be cheaper because you do not pay any other costs or copayments when you visit the doctor, fill a prescription or go to the hospital.

HIP Plus members pay an affordable monthly contribution, based on their income. The following table shows these amounts. If you are eligible for HIP and you are a tobacco user, you may have an increased POWER Account contribution (PAC) in your second year of coverage.

Your benefit year will be a calendar year running January to December. Your eligibility year will remain unique to you. You still have to go through your redetermination process each 12 months. This will occur based on what month you entered the program. You may change your health insurance provider during the open enrollment period from November 1 – December 15 each year.

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. With HIP Plus you can get 90 day refills on prescriptions you take every day and can receive medication by mail order.

HIP Basic benefits include all of the required essential health benefits. It does not include dental, vision or chiropractic services, or services for bariatric surgery and temporomandibular joint disorders (TMJ). And, there are more limits on annual visits to see physical, speech and occupational therapists. 

HIP Basic members do not have a simple, predictable monthly contribution. Instead they are responsible for paying for copayments at the time of service. Because of this, the HIP Basic plan could be more expensive than paying a monthly contribution for HIP Plus coverage.

Your benefit year will be a calendar year running January to December. Your eligibility year will remain unique to you. You still have to go through your redetermination process each 12 months. This will occur based on what month you entered the program.

Don’t have dental, vision, or chiropractic benefits? Take charge of your health next year and POWER Up with HIP Plus. Make sure you keep paying your POWER Account contributions to keep HIP Plus benefits.

Members who meet any of the following criteria will be enrolled in HIP State Plan.

• Section 1931 eligible parents and caretaker relatives eligible under 42 CFR 435.110 
• Low-income 19- and 20-year-old dependents eligible under 42 CFR 435.222 
• Members determined eligible for transitional medical assistance (TMA) by the State in accordance with Section 1925 of the Social Security Act 
• Individuals determined to be medically frail.

HIP State Plan benefits include all of the required essential health benefits, and some enhanced benefits such as dental and vision. HIP State Plan members may or may not have copays, depending if they are in the HIP State Plan Plus or HIP State Plan Basic.

Your benefit year will be a calendar year running January to December. Your eligibility year will remain unique to you. You still have to go through your redetermination process each 12 months. This will occur based on what month you entered the program.

HIP State Plan Plus Costs

HIP State Plan Plus members pay an affordable monthly contribution, based on their income. If you do not pay your monthly contribution on time, you will be moved to HIP State Plan Basic. 

HIP State Plan Basic Costs

HIP Basic members do not have a simple, predictable monthly contribution.

Instead you are responsible for paying for copayments at the time of service. Because of this, the HIP Basic plan could be more expensive than paying a monthly contribution to stay in HIP State Plan Plus. 

Are you pregnant? Tell us right away!

All you need to do is complete a Notification of Pregnancy survey. Get started:

• Sign into your Member Portal account and then fill out the Notification of Pregnancy form.
• Or, call an OB Nurse at 1-877-647-4848, Extension 20309 to complete it over the phone.

Pregnant HIP members’ benefits change so that:

• You will not pay a monthly POWER Account contribution (PAC) while pregnant.
• You will not have copays for healthcare services while pregnant.
• You get additional benefits, including transportation to and from your doctor visits, chiropractic services and Medicaid Rehabilitation Option (MRO services) while pregnant.
• You could also qualify for an additional $85 dollars of My Health Pays rewards.

These extra benefits make it easier to see your doctor so you can get important care during your pregnancy. These services will begin the first day of the month after you’ve reported your pregnancy to MHS and the Division of Family Resources (DFR).

Pregnancy benefits will end 12 months after your pregnancy ends. To avoid a gap in coverage, please tell MHS and the DFR as soon as your pregnancy ends. Log in to your portal account to fill out your “End of Pregnancy” form.