Healthy Indiana Plan (HIP Plan)
Welcome to the MDwise Healthy Indiana Plan (HIP). There is no copay for preventive services. All HIP members (Plus and Basic) will not contribute more than five percent of their family income. If you have paid for health care over five percent of your income in a calendar quarter, let us know.
You can also find important information about Hoosier Healthwise in your member handbook (English) | member handbook (Spanish).
There are two HIP plans. Each plan has different benefits.
HIP Plus
HIP Plus has no copayments except for the improper use of the emergency room. This means you won't have to pay when you visit the doctor, fill prescriptions or stay in the hospital. HIP Plus also includes dental and vision benefits. Members in HIP Plus contribute to a Personal Wellness and Responsibility Account (POWER Account). These monthly contributions to your POWER Account may be as low as $1 a month.
HIP State Plan Plus
HIP State Plan Plus is for people who have complex medical conditions, mental health disorders, or a substance use disorder. HIP State Plan Plus gives you more benefits and provides the best value coverage. You will pay a low, predictable monthly cost based on your income. This monthly cost is called your POWER Account contribution. With HIP State Plan Plus:
- Members pay their POWER Account contribution, which is a low monthly payment based on their income.
- Transportation services are covered.
- Members do not have to pay copays (except for using the emergency room when it’s not a true emergency).
- Dental services, vision services and chiropractic services are covered.
HIP Basic
HIP Basic offers limited benefits and can be more expensive than paying your low monthly HIP Plus POWER Account contribution. In HIP Basic, you must make a payment every time you receive a health care service.
- Copayments can cost between $4 to $8 per doctor visit or specialist visit.
- Copayments for preferred drugs are $4.
- Copayments for non-preferred drugs are $8.
- There is no copayment for preventive care, maternity services or family planning services.
- Copayments can be as high as $75 per hospital stay.
- HIP Basic covers essential health benefits, but has less benefits covered (for example, fewer therapy visits).
- HIP Basic does not include vision or dental coverage for members 21 and older.
- Fewer pharmacy options.
HIP State Plan Basic
HIP State Plan Basic is for people who have complex medical conditions, mental health disorders, or a substance use disorder. HIP State Plan Basic offers enhanced benefits such as vision, dental, chiropractic and transportation services. With HIP State Plan Basic, you will need to make a payment called a copayment for most health care services you receive. You will need to pay when you go to the doctor, fill a prescription or stay in the hospital.
- Copayments can cost between $4 to $8 per doctor visit or specialist visit.
- Copayments for preferred drugs are $4.
- Copayments for non-preferred drugs are $8.
- There is no copayment for preventive care, maternity services or family planning services.
- Copayments can be as high as $75 per hospital stay.
HIP State Plan Basic could cost more than paying the HIP State Plan Plus monthly POWER Account contribution.
HIP Maternity Plan
HIP Maternity Plan is for people who are pregnant and gives them more benefits!
With HIP Maternity Plan:
- No copays or POWER Account Contributions.
- Transportation services are covered.
- Dental services, vision services and chiropractic services are covered.
You must call FSSA or MDwise as soon as you find out you are pregnant. If you are pregnant when you apply and get accepted to HIP, you’ll automatically be put in the HIP Maternity plan.
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. You will receive 12 months of HIP Maternity coverage after your pregnancy ends for post-partum coverage.
When your pregnancy ends, report it to FSSA immediately at 1-800-403-0864.
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