Please also call MDwise as soon as you know your new address or phone number. You still have to go through your redetermination process each 12 months. Copayments for preferred drugs are $4. If a member does not wish to change health plans, they do not need to take any action and will automatically stay with their current health plan for the new year. Each Indiana Medicaid health plan serves different people and needs. One of the primary goals of the original HIP waiver was to reduce the uninsured.15 Prior to the ACA, states could only cover childless adults and receive federal Medicaid funds by obtaining a Section 1115 waiver. , and If you don't have a login, click on the blue "sign up for a new account" button. Hip vs Hep - What's the difference? | WikiDiff Mayo Clinic does not endorse companies or products. To participate in HIP Plus, members make affordable monthly contributions into their POWER account based on income. HIP Basic benefits also allow fewer visits to physical, speech and occupational therapists. 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. As a verb hip Eligibility and Enrollment Under the Waiver Extension. You get hurt and someone else may have to pay. Members with incomes above the poverty level, for example $14,580 a year for an individual, $19,720 for a couple or $30,000 for a family of four in 2023, that choose not to make their POWER account contributions will be removed from the program and not be allowed to re-enroll for six months. Address: 535 Diehl Road, Suite 100, Naperville, IL 60563. What happens if a HIP member becomes pregnant? what is the difference between hip and hoosier healthwise? The plan covers Hoosiers ages 19 to 64 who meet specific income levels. Fast Track is a payment option that allows eligible Hoosiers to expedite the start of their coverage in the HIP Plus program. If Indiana implemented the Medicaid expansion, the state could see an additional $17.3 billion, or 24%, increase in federal funds over the 2013-2022 period with small increases in state funding $537 million or a 1.3% increase after accounting for savings due to reduced uncompensated care costs. Your thighbone (femur) meets with your pelvis at your hip joint. The precise location of your hip pain can provide valuable clues about the underlying cause. Your monthly POWER Account contribution will be based on your income. Need information in a different language or format? 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. The HIP State Plan benefits grant you comprehensive coverage including vision, dental, non-emergency transportation, chiropractic services and Medicaid Rehabilitation Option services. Healthy Indiana Plan and the Affordable Care Act | KFF It is important to answer their questions to maintain HIP State Plan benefits. Members who have incomes below the federal poverty level who do not make their contributions will be moved to the HIP Basic plan. HIP Basic does not cover dental, vision or chiropractic services and charges a copayment for each service received. In contrast, POWER Accounts are administered by the managed care plans. HIP Plus is the initial, preferred plan selection for all members and offers the best value. Follow @SArtiga2 on Twitter HIP Plus has no copayments except for the improper use of the emergency room. What Is Hip Insurance - All Insurance FAQ 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Where and how can you pay your POWER account contribution? Billing or charging for a treatment, service or supply that is different than what you received. All claims must be submitted within 90 calendar days of the date of service. Examples of member fraud and abuse are: Members selling or lending their identification cards to people not covered by Hoosier Healthwise or the Healthy Indiana Plan. 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. Medicaid Members: Time is running out! This contribution can be split when spouses are both enrolled in HIP. 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. How to earn and redeem MDwiseREWARDS points. While the extension does not establish caps on parent enrollment, it allows Indiana to amend the waiver to change eligibility criteria for both parents and childless adults if the state finds that expenditures will exceed annual state funds. This will help us contact you about you and your familys important health care information. You can pay either the $10 Fast Track payment or your POWER account contribution amount. Fast Track allows you to make a $10 payment while your application is being processed. This joint is called a ball-and-socket . other information we have about you. All rights reserved. Anthem and MHS are established commercial plans in Indiana that serves some regular Medicaid enrollees. HOOSIER HEALTHWISE PLAN A Hoosier Healthwiseis a health care program for pregnant women andchildren. If your POWER account contribution is more than $10, then you will owe the balance in the first coverage month. In a letter to Secretary Sebelius from November 15, 2013, Governor Pence said that he was looking forward to further discussions regarding the potential expansion of the Healthy Indiana Plan; however, he also stated that it is essential that the State be able to maintain the consumer-driven model on which the program is predicated.19 CMS has raised issues about the monthly account contributions required under HIP. If your annual health care expenses are more than $2,500, the first $2,500 is covered by your POWER account, and expenses for additional health services are fully covered at no additional cost to you. Contribution amounts may be higher for smokers. 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. POWER account contributions are paid directly to the member's health plan (Anthem, MDwise, CareSource or MHS). In HIP, your contributions to your POWER account will be yours. The majority of states that have used Section 1115 waivers to expand Medicaid coverage to adults plan to implement the Medicaid expansion and transition current waiver coverage to new coverage under the ACA. *Please note that these costs are estimates. Hip dysplasia - Symptoms and causes - Mayo Clinic This enrollment lockout will not apply if the member is medically frail or residing in a domestic violence shelter or in a state-declared disaster area. Hoosier Healthwise Indiana Medicaid plans covers medical care like doctor visits, prescription medicine, mental health care, dental care, hospitalizations, surgeries, and family planning at little or no cost to the member or the members family. You can now pay your monthly POWER Account contribution with My Health Pays Rewards! There is no copay for preventative services. Compared to Indiana's Hoosier HealthWise (HHW) Medicaid population, . Carol Irvin, Healthy Indiana Plan: The First Two Years. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. The POWER Account is used to pay for the first $2,500 in health care costs. It's sponsored by the state and for some members requires a small monthly payment through your Personal Wellness and Responsibility (POWER) Account. The HIP Plus program provides comprehensive benefits including vision, dental and chiropractic services for a low, predictable monthly cost. HIP State Plan Plus is for people who have complex medical conditions, mental health disorders, or a substance use disorder. For more information see the. You will receive 12-months of HIP Maternity coverage after your pregnancy ends for post-partum coverage. Summary The contribution that will be one of five affordable amounts between $1 and $20. As enacted, the ACA called for an expansion of Medicaid for nearly all non-disabled adults with incomes at or below 138% of the Federal Poverty Level (FPL) that is largely funded with federal dollars. The waiver also allows for higher-cost sharing than otherwise allowed under the Medicaid program. Published: Dec 18, 2013. Unlike HIP Plus, HIP Basic does not cover dental, vision or chiropractic services. The only other cost you may have for health care in HIP Plus is a payment of $8 if you visit the emergency room when you dont have an emergency health condition. You may have someone make your Fast Track payment on your behalf. All HIP members (Plus and Basic) will not contribute more than five percent of their family income. You are offered the opportunity to make a Fast Track payment before you have been found eligible for HIP. Were here to help you with the latest information about your benefits, getting care and finding local help and resources. Go tohttp://www.in.gov/fssa/dfr/2999.htmto find the closet DFR office near you. (Mathematic Policy Research, July, 2010) http://www.in.gov/fssa/files/Presentation_to_Health_Study_Committee_Final_7_13_10.pdf and Rob Damler, Experience under the Healthy Indiana Plan: The short-term cost challenges of expanding coverage to the uninsured (Washington, DC: Milliman, August 2009), http://publications.milliman.com/research/health-rr/pdfs/experience-under-healthy-indiana.pdf. In HIP Plus, monthly POWER account payments are members only health care costs outside of any non-emergency visits to the emergency room. Don't lose your health care coverage! The Healthy Indiana Plan (HIP) is an affordable health plan for low-income adult Hoosiers between the ages of 19 and 64. This is not the case for HIP enrollees. Find a doctor, hospital, pharmacy or specialist that serves your plan. However, because enrollment in the program remains limited many poor uninsured adults who would be eligible for coverage under the Medicaid expansion will not gain access to coverage. Call our Behavioral Health Crisis Line at 833-874-0016. HIP Basic is the fallback option that is available only to members with household incomes less than or equal to the federal poverty level. HIP Basic option HIP Basic provides essential but limited health benefits. You will receive a Fast Track invoice from the Managed Care Entity (MCE) you selected to provide your health coverage. If they receive recommended preventive care services throughout the year, the discount will be doubled. To enroll in HIP Plus, eligible individuals must make a monthly contribution to their POWER Account to help cover initial health expenses. You may opt-out of email communications at any time by clicking on Download the free version of Adobe Reader. If you are involved in an accident, subrogation communication should be sent to: Multiplan As adjectives the difference between hip and hep is that hip is aware, informed, up-to-date, trendy while hep is aware, up-to-date. . Eligibility and Enrollment from 2008 2012. 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. 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. In Hip Basic HHW ACP PDL | CareSource It is okay to give it to your doctor, clinic, hospital, pharmacy, Hoosier Healthwise, Healthy Indiana Plan or MDwise customer service. Kaiser Commission on Medicaid and the Uninsured. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 How does someone qualify for Hoosier Healthwise? - IN.gov Please call the Member Services number on the back of your ID card. Hoosier Healthwise and Health Indiana Plan: 1-866-408-6131 . Need information in a different language or format? Unlike HIP Plus, you only get a 30-day supply of medications and cannot order them by mail. The recipient identification numbers (RIDs) for current HIP members who transition to the new HIP program will not . Income limits are adjusted to account for the number of household members. Letter from Governor Pence to Secretary Sebelius, November 15, 2013. We can mail you a list of these common services and their estimated reimbursement rates. This type of pain is called referred pain. Telling us about your other insurance will not reduce your MDwise benefits. Accessed May 6, 2016. Wilkinson JM (expert opinion). On September 3, 2013, Indiana obtained a one-year waiver extension from the Centers for Medicare and Medicaid Services (CMS) with some amendments primarily related to who is eligible for coverage. 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. It is the State of Indiana's health care program for children, pregnant women, and families with low income. Advertising revenue supports our not-for-profit mission. If you have other health insurance, please call 1-800-403-0864 to report this. No copays or POWER Account Contributions. Member Information | Hoosier Healthwise | MDwise As long as members make their required monthly POWER account contributions, they will have no other costs. To avoid a gap in coverage, please tell MHS and theDFR as soon as your pregnancy ends. information is beneficial, we may combine your email and website usage information with It also allows more visits for physical, speech and occupational therapy, and covers additional services like bariatric surgery and Temporomandibular Joint Disorderstreatment. Timothy Lake, Vivian Byrd, Seema Verma, Healthy Indiana Plan: Lessons for Health Reform (Washington, DC: Mathematica Policy Research, January 2011), http://www.mathematica-mpr.org/publications/PDFs/health/healthyindianaplan_ib1.pdf, Enrollees may change plans for cause such as: failure of insurer to provide covered services; failure of insurer to comply with established standards of medical administration; significant language or cultural barriers; corrective action levied against the insurer by the state. MDwise is an Indiana-based, nonprofit health plan. Pregnant members are eligible to receive incentives for completing preventive care like all other HIP members. You can also call MDwise customer service at 800.356.1204. 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. Every HIP member has a POWER account. Parents below 22% were eligible for regular Medicaid before implementation of the Healthy Indiana Plan, and continue to receive regular Medicaid coverage. Call CareSource Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711) if you have any questions about your benefits. In HIP, if your annual health care expenses are less than $2,500 per year you may rollover your remaining contributions to reduce your monthly payment for the next year. Will my health condition(s) affect the coverage I receive? The state pays most of the $2,500, and if you arein HIP Plus or HIP State Plan Plus, you are responsible for paying a portion. Opens in a new window. Babies sleep safest when they are alone, on their back, and in a crib. You receive this handbook when you become a MDwise member. 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. Kaiser Commission on Medicaid and the Uninsured, A Look at Section 1115 Medicaid Demonstration Waivers Under the ACA: A Focus on Childless Adults. Click here for a comparison of the available health plans. If you do not make a Fast Track payment, you may face a delay in the start of your coverage. 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. Carry your member ID card with you at all times. information and will only use or disclose that information as set forth in our notice of Learn more about the Healthy Indiana Plan (HIP) and enroll today! Members pay their POWER Account contribution, which is a low monthly payment based on their income. Physical, mental or sexual abuse by medical staff. The Healthy Indiana Planhas two pathways to coverage HIP Plus and HIP Basic. 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. (HDHP) and HSA, there are key differences between the structure of the HIP and a HDHP-HSA. During diaper changes, one hip may be less flexible than the other. Check your symptoms with our symptom checker. Download the free version of Adobe Reader. The member pays an affordable monthly POWER account contribution based on income. Accessibility
As of January 2014, individuals with incomes above 100% FPL will be eligible for premium tax credits to help purchase coverage through the new Health Insurance Marketplaces established by the ACA. 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. A formulary is a list of some of the brand and generic medicines covered by Hoosier Healthwise. Based on family income, children up to age 19 may be eligible for coverage. HIP State Plan Plus members pay an affordable monthly contribution, based on their income. Make sure MDwise always has your correct address and phone number. If you are a Mayo Clinic patient, this could The study also found that individuals who enrolled earliest had the highest average risk scores suggesting that the most severe adverse selection was when the program was first implemented.4 At the end of 2012, most (70%) of the 39,005 total enrollees in HIP were poor and nine in ten (90%) had income below 150% of poverty.5 Nearly one in three (29%) was age 50 or older.6 Race distribution has stayed relatively steady over the course of the demonstration with over eight in ten identifying as White, one in ten as Black, and the remaining 7% identifying as either Hispanic or Native American.7. 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, Hoosier Healthwise member handbook (English), Hoosier Healthwise member handbook (Spanish), Hoosier Healthwise Member Consent Form (English), Hoosier Healthwise Member Consent Form (Spanish), Care Management/Disease Management Referral Form (English), Care Management/Disease Management Referral Form (Spanish), Congestive Heart Failure Weight Log (English), Congestive Heart Failure Weight Log (Spanish), MDwise list of common medical services and estimated reimbursement rates (English), MDwise list of common medical services and estimated reimbursement rates (Spanish), Nondiscrimination/Accessibility (English), Nondiscrimination/Accessibility (Spanish).