Haris Ashley
The Healthy Indiana Plan (HIP) is a health insurance program for qualified adults. It is a consumer-driven health coverage program for non-disabled Hoosiers between the ages of 19 and 64. The plan offers incentives for members to take personal responsibility for their health and rewards them for taking better care of it. It also provides health coverage to low-income Hoosiers and ensures an adequate provider network for both HIP and Medicaid enrollees. The HIP Plus program provides comprehensive benefits, including vision, dental, and chiropractic services, while the HIP Basic program offers essential health benefits without covering vision, dental, or chiropractic services.
| Characteristics | Values |
|---|---|
| Plan Name | Healthy Indiana Plan (HIP) |
| Administering Body | State of Indiana |
| Target Group | Non-disabled Hoosiers aged 19-64 |
| Income Criteria | Less than approximately 138% of the federal poverty level |
| Eligibility Criteria | Not eligible for Medicare or another Medicaid category |
| Plan Options | HIP Plus, HIP Basic |
| HIP Plus Contributions | Monthly payments into a Personal Wellness and Responsibility (POWER) account |
| HIP Plus Benefits | Vision, dental, chiropractic services, physical/speech/occupational therapy, bariatric surgery, TMJ treatment, 90-day prescription refills, mail-order medication |
| HIP Basic Benefits | All federally required essential health benefits |
| HIP Basic Payments | $4 to $8 per doctor visit or prescription, up to $75 per hospital stay |
| Additional Coverage | Medicaid for Indiana Health Coverage Programs (IHCP) members aged 65+ or with blindness/disability |
| Out-of-Network Coverage | Generally not covered, except for emergencies |
| Provider Network | QualCare, ConnectiCare, Prime Network (100,000+ doctors in NY, NJ, CT) |
| Additional Services | Telemedicine, medication therapy management, lifestyle coaching, mental health and substance abuse programs |
Explore related products
What You'll Learn
- The Healthy Indiana Plan (HIP) is a health insurance program for qualified adults in Indiana
- HIP Plus is the initial, preferred plan with the best value
- HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level
- HIP provides incentives for members to take personal responsibility for their health
- HIP covers vision, dental, and chiropractic services
The Healthy Indiana Plan (HIP) is a health insurance program for qualified adults in Indiana
There are two types of plans under HIP: HIP Plus and HIP Basic. HIP Plus is the initial, preferred plan selection for all members, offering the best value. It includes dental, vision, and chiropractic services and has no copayments except for non-emergency use of the emergency room. To enroll in HIP Plus, members make affordable monthly contributions to their Personal Wellness and Responsibility (POWER) account based on income.
HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level. In HIP Basic, members make a payment every time they receive a healthcare service, such as going to the doctor, filling a prescription, or staying in the hospital. These payments range from $4 to $8 per doctor visit or prescription filled and can be as high as $75 per hospital stay. HIP Basic includes all the federally required essential health benefits but does not cover vision, dental, or chiropractic services.
The Healthy Indiana Plan also covers Indiana residents over the age of 65 or those with blindness or a disability through their Medicaid program. This has expanded coverage to hundreds of thousands of Hoosiers who previously lacked insurance options.
HIP members can change their health insurance provider during the open enrollment period from November 1 to December 15 each year.
Providing Medical Insurance Copies: A Quick Guide
You may want to see also
Explore related products
HIP Plus is the initial, preferred plan with the best value
The Healthy Indiana Plan (HIP) is a health insurance program offered by the State of Indiana. It provides health coverage for Indiana residents between the ages of 19 and 64 whose family incomes are less than approximately 138% of the federal poverty level. The plan also covers individuals with disabilities, blindness, or those aged 65 and over.
HIP Plus provides more benefits than the HIP Basic program. In addition to vision, dental, and chiropractic services, HIP Plus covers physical, speech, and occupational therapy, with more visits allowed under this plan. It also covers additional services like bariatric surgery and Temporomandibular Joint Disorders treatment. Furthermore, HIP Plus offers the convenience of 90-day refills on prescriptions and the option to receive medication by mail order.
The HIP Basic plan is available to members with household incomes at or below the federal poverty level. This plan requires members to make a payment every time they receive a healthcare service, such as a doctor's visit, prescription, or hospital stay. These copayments can range from $4 to $8 per doctor visit or prescription and up to $75 per hospital stay. While HIP Basic includes all the federally required essential health benefits, it does not provide coverage for vision, dental, or chiropractic services, or additional services like bariatric surgery. In some cases, HIP Basic can be more expensive than HIP Plus due to the cumulative copayments.
How Teens Can Get Their Own Health Insurance
You may want to see also
Explore related products
HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level
The Healthy Indiana Plan (HIP) is a health insurance program offered by the State of Indiana for qualified adults. It covers Indiana residents between the ages of 19 and 64 whose family incomes are less than approximately 138% of the federal poverty level. The HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level.
HIP Basic is available only to members with household incomes less than or equal to the federal poverty level. 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. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. HIP Basic can be more expensive than HIP Plus.
HIP Basic includes all the federally required essential health benefits but does not provide coverage for vision, dental, or chiropractic services, bariatric surgery, or temporomandibular joint disorders. It is important to note that members with family incomes at or below the federal poverty level will default to HIP Basic if they do not make their POWER Account contribution.
The Healthy Indiana Plan provides incentives for members to take personal responsibility for their health. In each calendar year, the first $2,500 of a member's medical expenses for covered benefits are paid with a special savings account called a Personal Wellness and Responsibility (POWER) account. The state pays most of this amount, but members are also responsible for paying a small portion of their initial healthcare costs.
HIP continues to build on the successes of the original design and lessons learned since its initial implementation in 2008. It provides health coverage to low-income Hoosiers and ensures an adequate provider network for both HIP and Medicaid enrollees. The program empowers participants to make cost- and quality-conscious healthcare decisions and creates pathways to jobs that promote independence from public assistance.
Weight Loss Medication: Insurance Companies' Refusal Explained
You may want to see also
Explore related products
HIP provides incentives for members to take personal responsibility for their health
The Healthy Indiana Plan (HIP) is a health insurance program offered by the State of Indiana. It provides health coverage for Indiana residents aged 19 to 64 from low-income households. HIP empowers its members to take personal responsibility for their health by incentivizing them to make cost- and quality-conscious healthcare decisions.
HIP offers two plans: HIP Basic and HIP Plus. HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level. Under this plan, members pay a fee ranging from $4 to $8 for each doctor visit or prescription filled, and up to $75 per hospital stay. HIP Basic does not cover vision, dental, or chiropractic services, and members must pay a copayment for each service received.
HIP Plus, on the other hand, provides more comprehensive benefits, including vision, dental, and chiropractic care. It also covers additional services like bariatric surgery and Temporomandibular Joint Disorder treatments. With HIP Plus, members do not pay copayments when they visit a doctor, fill a prescription, or go to the hospital, except for non-emergency use of the emergency room. To enroll in HIP Plus, members must make affordable monthly contributions to their Personal Wellness and Responsibility (POWER) account, which covers initial health expenses.
In both plans, members are incentivized to take personal responsibility for their health. For example, under HIP Plus, members who choose to leave the program early will have their contributions to their POWER account returned if they have not been spent on healthcare costs. Additionally, medication therapy management services are provided to ensure that prescription therapies are safe and effective.
HIP also offers resources such as one-on-one, group, or text message coaching from trained health coaches or nurse wellness coaches at no extra cost. These coaches help members make lifestyle changes and navigate the healthcare system, rewarding them for adopting healthy habits. Overall, HIP's approach to incentivizing personal responsibility for health aims to create a healthier future for its members while also reducing healthcare costs.
Medical Insurance Companies in Washington: A Comprehensive Overview
You may want to see also
Explore related products
HIP covers vision, dental, and chiropractic services
The Healthy Indiana Plan (HIP) is a health insurance program offered by the State of Indiana. It provides health coverage for Indiana residents aged 19 to 64 whose family incomes are less than approximately 138% of the federal poverty level and who aren't eligible for Medicare or other Medicaid categories. The plan also extends to those aged 65 and over, or with blindness or a disability.
HIP has two pathways to coverage: HIP Plus and HIP Basic. HIP Plus is the initial and preferred plan selection, offering the best value. It provides comprehensive benefits, including vision, dental, and chiropractic services, for a low, predictable monthly cost. Members do not pay copayments when visiting doctors or hospitals or filling prescriptions. The only exception is a copayment for non-emergency use of the emergency room. To enrol in HIP Plus, eligible individuals must make a monthly contribution to their Personal Wellness and Responsibility (POWER) account.
On the other hand, HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level. In this plan, members make a payment every time they receive a healthcare service, such as doctor visits, prescriptions, or hospital stays. These payments may range from $4 to $8 per doctor visit or prescription and may go as high as $75 per hospital stay. Notably, HIP Basic does not cover vision, dental, or chiropractic services.
While HIP Basic includes all the federally required essential health benefits, it does not provide the additional coverage offered by HIP Plus. This includes vision, dental, and chiropractic services, as well as coverage for bariatric surgery and Temporomandibular Joint Disorders (TMJ) treatment. HIP Plus allows for more visits for physical, speech, and occupational therapy and offers the convenience of 90-day refills on prescriptions and medication delivery by mail.
Get Your Medical History Without Insurance: A Guide
You may want to see also
Frequently asked questions
The Healthy Indiana Plan is a health insurance program offered by the State of Indiana for qualified adults. It covers medical, vision, dental, and chiropractic costs for Indiana residents aged 19-64.
HIP Plus is the preferred plan with the best value. It offers comprehensive benefits, including vision, dental, and chiropractic services, for a low, predictable monthly cost. Members do not pay copayments when they go to the doctor or fill a prescription. HIP Basic is the fallback option for members with household incomes less than or equal to the federal poverty level. It does not include dental, vision, or chiropractic services, and members must make a payment every time they receive a healthcare service.
To be eligible for HIP, you must be an Indiana resident aged 19-64 with a family income of less than approximately 138% of the federal poverty level. You must also not be eligible for Medicare or another Medicaid category. You can check your eligibility and estimate your monthly POWER account contribution using the calculator on the official HIP website.
