Carry your member ID card with you at all times. HIP Plus provides MORE benefits than the HIP Basic program, including vision, dental and chiropractic services. 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. These HIP State Plan benefits will continue as long as your health condition, disorder or disability status continues to qualify you as medically frail. Hoosier Healthwise (HHW) is one of the Indiana Medicaid programs. Only go to the emergency room for true medical emergencies. 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. Click here for a comparison of the available health plans. Hip pain is a common complaint that can be caused by a wide variety of problems. Take action to keep your health care coverage. HIP Basic benefits also allow fewer visits to physical, speech and occupational therapists. Heres 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. In Hip Basic HHW ACP PDL | CareSource HIP continues to build on the successes of the original design and lessons learned since initial implementation in 2008. If no plan is choose a health plan, one will be assigned. Check your symptoms with our symptom checker. HIP Plus allows members to make a monthly contribution to your POWER account based on income. It is okay to give it to your doctor, clinic, hospital, pharmacy, Hoosier Healthwise, Healthy Indiana Plan or MDwise customer service. This is called prior authorization. Kaiser Commission on Medicaid and the Uninsured, A Look at Section 1115 Medicaid Demonstration Waivers Under the ACA: A Focus on Childless Adults. HIP is offered by the state of Indiana. Members who leave HIP and return in the same calendar year will still have their same POWER account and health plan. Hoosier Healthwise | MDwise. HIP provides incentives for members to take personal responsibility for their health. What's the difference between HIP Basic and HIP Plus? Offering you free services, equipment or supplies in exchange for use of your Hoosier Healthwise or Healthy Indiana Plan number. And, there are more limits on annual visits to see physical, speech and occupational therapists. Healthy Indiana Plan | MDwise Member Information | Hoosier Healthwise | MDwise There is no copay for preventative services. This will help us contact you about you and your familys important health care information. Members selling or lending their identification cards to people not covered by Hoosier Healthwise or the Healthy Indiana Plan. Contact your doctor first for all medical care. Download the free version of Adobe Reader. Click hereto learn how you can earn My Health Pays rewards. The Healthy Indiana Plan (HIP) is an affordable health plan for low-income adult Hoosiers between the ages of 19 and 64. Welcome to the MDwise Healthy Indiana Plan (HIP). How HIP Basic works Copays If you need help picking the right health plan for you, call 1-877-GET-HIP-9. Your thighbone (femur) meets with your pelvis at your hip joint. The HIP State Plan benefits grant you comprehensive coverage including vision, dental, non-emergency transportation, chiropractic services and Medicaid Rehabilitation Option services. New members get 90 days to decide if they want to stay in the MDwise plan. (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. FSSA: HIP: Frequently Asked Questions 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 Plus coverage begins the first of the month in which an individual makes their POWER account contribution or makes a $10 Fast Track payment. HIP State Plan Plus is for people who have complex medical conditions, mental health disorders, or a substance use disorder. what is the difference between hip and hoosier healthwise? HIP Basic can be more expensive that HIP Plus. Please review it carefully. You get additional benefits, including transportation to and from your doctor visits, chiropractic services and Medicaid Rehabilitation Option (MRO services) while pregnant. When do HIP members select their health plan? You may opt-out of email communications at any time by clicking on It is the State of Indiana's health care program for children, pregnant women, and families with low income. Billing or charging for a treatment, service or supply that is different than what you received. Download the free version of Adobe Reader. Find a doctor, hospital, pharmacy or specialist that serves your plan. After making the payment you may not change your MCE/health plan, so be sure you select the right one for you. The CommonGround Recovery Library offers strategies and tools to help you start the recovery process and deal with daily challenges. You will be exempt from cost-sharing and will not lose coverage for change in household status that would normally result in loss of eligibility. Managing your account well and getting preventive care can reduce your future costs. A penalty is deducted if an individual is disenrolled due to non-payment or withdrawing from the program without having other coverage. You may change your health plan selection before paying your Fast Track invoice by calling 1-877-GET-HIP-9. This is not the case for HIP enrollees. Healthy Indiana Plan and the Affordable Care Act | KFF HIP Basic members will be given the opportunity to re-enroll in HIP Plus at the end of their annual cycle, or plan year, defined by their enrollment date. The contributions you make to your new POWER account will be yours. Eligibility and Enrollment from 2008 2012. Need help with some of the HIP terms? HIP Plus is the plan for the bestvalue. Frequently Asked Questions | MHS Indiana 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. View your claims (if applicable to your plan). In: Kelley's Textbook of Rheumatology. If you make the contribution in August, you will begin HIP Plus August 1. PDF IHCP bulletin - Indiana Medicaid All rights reserved. HIP Basic plan members will still receive POWER account statements to assist them in managing the account and to increase their awareness of the cost of the health care services they receive. This portion was about 35% in 2008 and has decreased to about 21% of enrollees in 2010 through 2012. Hip vs Hips - What's the difference? | WikiDiff With the Sydney Health mobile app, you can: Hoosier Healthwise and Health Indiana Plan: Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross and Blue Shield Association. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. Carol Irvin, Healthy Indiana Plan: The First Two Years. 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). Share on Facebook. Go tohttp://www.in.gov/fssa/dfr/2999.htmto find the closet DFR office near you. HOOSIER HEALTHWISE PLAN A Hoosier Healthwiseis a health care program for pregnant women andchildren. 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. Once the open enrollment period ends, you will stay enrolled in your chosen health plan for the rest of the 12 month period unless you lose your Hoosier Healthwise eligibility. 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. Make sure you keep paying your POWER Account contributions to keep HIP Plus benefits. 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. These services will begin the first day of the month after youve reported your pregnancy to MHS and theDivision of Family Resources (DFR). It does not include dental, vision or chiropractic services, or services for bariatric surgery and temporomandibular joint disorders (TMJ). 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). Your eligibility year will remain unique to you. Pregnant women who would otherwise be eligible for HIP but are not enrolled may receive a new member card indicating they are enrolled in HIP Maternity. Try this guide, complete a form that gives them permission to make this payment (PDF). CMS guidance specifies that states will not be eligible for enhanced matching funds from the ACA if there is a cap on enrollment or a partial expansion. Unlike HIP Plus, HIP Basic has more limited options for getting medication. Parents below 22% were eligible for regular Medicaid before implementation of the Healthy Indiana Plan, and continue to receive regular Medicaid coverage. We can mail you a list of these common services and their estimated reimbursement rates. Visit in.gov to learn more. This content does not have an English version. Show your card every time you get health care. HIP Maternity members will receive vision, dental, chiropractic coverage, non-emergency transportation and access to additional smoking cessation services designed specifically for pregnant women. Second, individuals manage their HSAs and can use it to pay for a broad set of medical expenses. You can also contact your local DFR office. How to earn and redeem MDwiseREWARDS points. Every calendar year, members get a new $2,500 POWER account amount to pay for HIP covered medical expenses. 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. As adjectives the difference between hip and hips You could also qualify for an additional $85 dollars of My Health Pays rewards. The Healthy Indiana Planhas two pathways to coverage HIP Plus and HIP Basic. As such, section 1115 waivers that to expanded coverage to adults often included limited benefit packages, higher cost-sharing and/or enrollment caps to limit costs. 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. Accessibility Issues, Provide quality coverage choices for Hoosiers, Provide additional substance use disorder services to address the opioid crisis, Provide health coverage to low-income Hoosiers and ensure an adequate provider network for both HIP and Medicaid enrollees, Empower participants to make cost- and quality-conscious health care decisions, Create pathways to jobs that promote independence from public assistance, Physical, intellectual or developmental disability that significantly impair the individuals ability to perform one or more activities of daily living; or. This will occur based on what month you entered the program. You will not have the opportunity to change your health plan untilHealth Plan Selection in the fall. Prior to the enactment of the Affordable Care Act (ACA), a number of states used Section 1115 Medicaid Demonstration Waivers to expand coverage to adults and to operate Medicaid programs in ways not otherwise allowed under federal rules. 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. A portion of enrollees do not contribute to POWER accounts and the state pays the full amount. Call Member Services at 1-877-647-4848 to make a payment with rewards today. A POWER account is a special savings account that members use to pay for health care. 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. Only make a payment to the health plan that you want to be your HIP coverage provider. Governor Pence remains committed to expanding Healthy Indiana and continuing discussions with CMS. Your benefit year will be a calendar year running January to December. After the 12 month period members will transfer from HIP Maternity to HIP Basic to get HIP Plus benefits the member will need to make a POWER account contribution. Kaiser Commission on Medicaid and the Uninsured. The independent source for health policy research, polling, and news. HIP Basic members do not have a simple, predictable monthly contribution. HIP State Plan benefits include all of the required essential health benefits, and some enhanced benefits such as dental and vision. These include by mail, over the phone, online and via payroll deduction through the member's employer. Review/update the The filing limit may be extended for newborn claims when the eligibility has been retroactively received by MHS, up to a maximum of 365 calendar days for services provided . Enhanced benefits are available to individuals whose health status qualifies them as medically frail. 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. Members who indicate that they are tobacco users during the plan selection period in the fall, may be subject to an increased contribution amount in the following year if they are still smoking. 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. The member will continue to have a POWER account but will not be required to make payments. You still have to go through your redetermination process each 12 months. Indiana can continue to evaluate how it will proceed and whether it will adopt the Medicaid expansion as they continue to offer coverage through the HIP waiver that will expire at the end of 2014. Dont have dental, vision, or chiropractic benefits? You can now pay your monthly POWER Account contribution with My Health Pays Rewards! Letter from Governor Pence to Secretary Sebelius, November 15, 2013. Members do not have to pay copays (except for using the emergency room when its not a true emergency). You are offered the opportunity to make a Fast Track payment before you have been found eligible for HIP. 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. Fast Track allows members to make a $10 payment while their application is being processed. This analysis assumes childless adults and parents with incomes above 24% ($4,697 annually) would fall into the coverage gap. Telling us about your other insurance will not reduce your MDwise benefits. Follow. The only exception to this is a charge of $8 if a member goes to the hospital emergency room for a non-emergency. Follow @RRudowitz on Twitter Copyright 2023 State of Indiana - All rights reserved. Or, call an OB Nurse at 1-877-647-4848, Extension 20309 to complete it over the phone. Members will receive information from their health plans about the various ways POWER account contributions can be paid. 2023 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. Based on family income, children up to age 19 may be eligible for coverage. Need help with some of the HIP terms? 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. You may change your health insurance provider during the open enrollment period from November 1 December 15 each year. 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). John Holahan, Matthew Buettgens, and Stan Dorn. The members portion is an affordable, monthly contribution based on income. HIP State Plan Plus members pay an affordable monthly contribution, based on their income. All rights reserved. Review your member handbook for important information, Some services need approval from MDwise before you get them. Anthem and MHS are established commercial plans in Indiana that serves some regular Medicaid enrollees. How does someone qualify for Hoosier Healthwise? - IN.gov If they receive recommended preventive care services throughout the year, the discount will be doubled. Accessibility Contracted providers (A medical provider that has an agreement with MHS to accept their patients at a previously agreed upon rate of payment):. privacy practices. Call 877-GET-HIP-9 to learn more about the application process or click here to find your local DFR office. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Health needs screening: Get up to a $30 gift card, Privacy Guidance When Selecting Third-Party Apps - English, Privacy Guidance When Selecting Third-Party Apps - Spanish. For help making your selection, call 1-877-GET-HIP-9. MDwise Hoosier Healthwise members can call 1-844-336-2677 to ask about medicines that are covered. In HIP Basic, members make a payment every time they receive a health care service, such as going to the doctor, filling a prescription or staying in the hospital. Download the free version of Adobe Reader. If you need messages in a different language or format like large print, audio, or Braille, let us help. Do not give your member ID card or MDwise card number to anyone. For example if your POWER account is $15, then your $10 payment will be applied to your first months coverage. By doing so, these states will receive the enhanced federal matching funds for this coverage. As nouns the difference between hip and hips is that hip is the outward-projecting parts of the pelvis and top of the femur and the overlying tissue while hips is plural of lang=en. Need information in a different language or format? Contribution amounts may be higher for smokers. Call our Behavioral Health Crisis Line at 833-874-0016. 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. A hip pinning is a type of surgery to fix a broken (fractured) hip. Pregnant women enrolled in Hoosier Healthwise will not be affected by changes to the Healthy Indiana Plan and will continue to receive coverage through Hoosier Healthwise. HIP Basic HIP Basic is the fallback option for members with household income less than or equal to 100 percent of the federal poverty levelwho don't make their POWER account contributions. 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. MHS will provide it at no cost to you. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. States could also see additional savings and broader economic benefits from the increases in coverage and federal financing.18 Under the waiver renewal, Indiana is not eligible for enhanced federal matching funds and continues to receive the states regular match rate for adults covered under the waiver. The state also will not be able to access the enhanced federal matching funds tied to new coverage that is available to states implementing the Medicaid expansion. You can also call MDwise customer service. As a MDwise Hoosier Healthwise member, remember these basic rules: The MDwise member handbookis the best place to go to understand your benefits and services. Is Hoosier Indiana Plan The Same As Health Indiana Plan
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