what is the difference between hip and hoosier healthwise?

It is the State of Indiana's health care program for children, pregnant women, and families with low income. Our clinicians are available 24 hours a day, 7 days a week to talk with you and give the assistance you need. All rights reserved. MDwise Hoosier Healthwise members can call 1-844-336-2677 to ask about medicines that are covered. Poor adults who are not enrolled in the waiver will remain ineligible for Medicaid and they also will be ineligible for tax credits for Marketplace coverage, which begin at 100% FPL. It's sponsored by the state and for some members requires a small monthly payment through your Personal Wellness and Responsibility (POWER) Account. This content does not have an English version. You will pay a low, predictable monthly cost based on your income. We can help. 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 may opt-out of email communications at any time by clicking on Please note thatalthough these letters may say that payments are due, there are no payments due at this time. Medicare is managed by the federal government and is mainly based on age. Call your health plan for details about these options and locations. You will not have the opportunity to change your health plan untilHealth Plan Selection in the fall. include protected health information. Review your member handbook for important information, Some services need approval from MDwise before you get them. Hip diagnosis and decision making. MHS will provide it at no cost to you. Once you pay your Fast Track invoice you may not change your MCE/health plan. 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. The HIP Plus program provides comprehensive benefits including vision, dental and chiropractic services for a low, predictable monthly cost. The benefits also include preventive care, such as well-baby and well-child care and regular check- ups, and mental health and substance abuse treatment. A hip pinning is a type of surgery to fix a broken (fractured) hip. Members are limited to 30-day prescription supply and cannot order medications by mail. To change your doctor, please call MDwise customer service. Act now to keep your MDwise health coverage. If you have other health insurance, please call 1-800-403-0864 to report this. It also allows more visits for physical, speech and occupational therapy, and covers additional services like bariatric surgery and Temporomandibular Joint Disorderstreatment. 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. 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. HIP Plus also includes dental and vision benefits. If you have paid for health care over five percent of your income in a calendar quarter, let us know. You get hurt and someone else may have to pay. Fast Track is a payment option that allows eligible Hoosiers to expedite the start of their coverage in the HIP Plus program. Members who make POWER account contributions on-time each month participate in HIP Plus where they have better benefits and predictable costs. 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. 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. 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. Members can select their health plan when they apply. Review/update the Accessed May 6, 2016. Members do not have to pay copays (except for using the emergency room when its not a true emergency). Learn more about the MHS plans for Medicaid members below. You can now pay your monthly POWER Account contribution with My Health Pays Rewards! 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. The member pays an affordable monthly POWER account contribution based on income. As approved in 2008, HIP expanded coverage to parents with dependent children with incomes above the states eligibility limit for full Medicaid coverage (22% FPL) and below 200% FPL and other adults with incomes between 0% and 200% FPL. The state will pay most of this amount, but the member is also responsible for paying a small portion of their initial health care costs. If you do not make a Fast Track payment, you may face a delay in the start of your coverage. 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. Your eligibility year will remain unique to you. The Healthy Indiana Planhas two pathways to coverage HIP Plus and HIP Basic. The ACA Medicaid expansion eliminates the need for states to obtain a Section 1115 waiver to cover adults. Members will have 60 days to make their POWER account contribution from the start of the HIP Basic benefits. For more information see the. Every HIP member has a POWER Account. Hoosier Healthwise | MDwise. The contributions you make to your new POWER account will be yours. Hoosier Healthwise is a health care program for children up to age 19 and pregnant individuals. Income limits are adjusted to account for the number of household members. Evaluation of the adult with hip pain. Settings, Start voice http://www.uptodate.com/home. If you want to know about a specific service that is not listed, please call MDwise customer service and we will research it for you. This portion was about 35% in 2008 and has decreased to about 21% of enrollees in 2010 through 2012. Click hereto learn how you can earn My Health Pays rewards. 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. The HIP Basic plan will charge copayments for health care services. Check your symptoms with our symptom checker. A 2009 study found that compared to the commercially insured population in Indiana, the HIP population had higher utilization, costs, frequency of disease and morbidity. DeLee JC, et al. During this time you will have another chance to choose a new health plan. the unsubscribe link in the e-mail. View your claims (if applicable to your plan). Summary What is HIP power account? 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 dont have an emergency health condition. Were here to help you with the latest information about your benefits, getting care and finding local help and resources. Where and how can you pay your POWER account contribution? 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. Because of this, the HIP Basic plan could be more expensive than paying a monthly contribution to stay in HIP State Plan Plus. Without implementing the ACA Medicaid expansion, Indiana also will forgo significant amounts of federal financing. 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. The independent source for health policy research, polling, and news. HIP State Plan Plus gives you more benefits and provides the best value coverage. CMS extended the plan to not disrupt the coverage currently afforded in Indiana as the state continues to consider its coverage options.1 While this temporarily preserves coverage for many adults currently covered by the waiver, it also leaves many who would be eligible under the ACAs full Medicaid expansion without access to new coverage options. POWER account contributions are a key part of the Healthy Indiana Plan. This joint is called a ball-and-socket . It is the State of Indianas health care program for children, pregnant women, and families with low income. As long as members make their required monthly POWER account contributions, they will have no other costs. A disability determination based on Social Security Administration criteria. By doing so, these states will receive the enhanced federal matching funds for this coverage. When your pregnancy ends, report it to FSSA immediately at 1-800-403-0864. The plan covers Hoosiers ages 19 to 64 who meet specific income levels. Members with income over the federal poverty level who do not pay for Plus will lose eligibility for HIP Basic after 60 days. Mayo Clinic does not endorse companies or products. There are two HIP plans. Offering you free services, equipment or supplies in exchange for use of your Hoosier Healthwise or Healthy Indiana Plan number. Physical, mental or sexual abuse by medical staff. How HIP Basic works Copays You can also contact your local DFR office. . If your income is more than this amount, you will need to reapply for coverage to begin HIP. Parents below 22% were eligible for regular Medicaid before implementation of the Healthy Indiana Plan, and continue to receive regular Medicaid coverage. You can search by city and state, specialty, and plan. 2023 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. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota. New members get 90 days to decide if they want to stay in the MDwise plan. Pregnancy benefits will end 12 months after your pregnancy ends. HIP Plus provides MORE benefits than the HIP Basic program, including vision, dental and chiropractic services. A member wishing to change health plans may do so by calling 877-GET-HIP-9 between November 1 and December 15. You could also qualify for an additional $85 dollars of My Health Pays rewards. HIP State Plan Basic offers enhanced benefits such as vision, dental, chiropractic and transportation services. You receive this handbook when you become a MDwise member. Read more on our blog. Accessed May 6, 2016. This may be more or less than $10 per month. You can pay either the $10 Fast Track payment or your POWER account contribution amount. , and Eligibility and Enrollment Under the Waiver Extension. other information we have about you. Use our Community Resource Link for local help finding food, housing and other things you might need. 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. Current HIP, Hoosier Healthwise, and family planning enrollees will begin receiving notice of new HIP enrollment options in mid- to late January 2015. Indiana extended coverage for individuals between 100 and 200% until April 30, 2014 due to issues enrolling in the federal marketplace. Members also receive medication therapy management services that are designed to work closely with their doctors and pharmacies to provide additional assurances that prescription therapies are safe and effective. This analysis assumes childless adults and parents with incomes above 24% ($4,697 annually) would fall into the coverage gap. Ensure state fiscal responsibility and efficient management of the program. 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. 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. Under the plan, Indiana uses Medicaid funds to provide a benefit package modeled after a high-deductible health plan and health savings account to previously uninsured very poor and low-income adults. Log in to the system to make your change. Letter from Governor Pence to Secretary Sebelius, November 15, 2013. Advertising revenue supports our not-for-profit mission. No copays or POWER Account Contributions. You still have to go through your redetermination process each 12 months. Your eligibility year will remain unique to you. In HIP, your contributions to your POWER account will be yours. 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 they receive recommended preventive care services throughout the year, the discount will be doubled. If you or your child has other health insurance, you must let us know. Types of income include earned (example: wages from a job), unearned income (example: Social Security Disability payments) and countable income (e.g., taxable income plus certain Social Security Income and lump sum income. 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. Managing your account well and getting preventive care can reduce your future costs. Get health news, healthy lifestyle tips, and more on our blog. The one year extension of HIP preserves coverage for the parents and other adults currently covered by the program. Welcome to the MDwise Hoosier Healthwise plan. 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. A new version is published every three months. All you need to do is complete a Notification of Pregnancy survey. If no plan is choose a health plan, one will be assigned. If you fail to verify your condition at the request of your health plan, you could still have access to comprehensive coverage including vision and dental, by participating in HIP Plus, but you would lose access to the additional HIP State Plan benefits including coverage for non-emergency transportation. Do not let anyone borrow or use your member ID card. Hip and knee pain. If you are just joining HIP and want to make sure you choose a health plan that includes your doctor, call 877-GET-HIP-9 to discuss your options. Copyright 2023 State of Indiana - All rights reserved. The member contribution amounts are between $1 and $20, but may be higher for members that smoke. Pregnant members will continue to not have any cost sharing responsibilities during this period. A POWER account is a special savings account that members use to pay for health care. The MDwise Steps to Wellness newsletter provides information on Hoosier Healthwise and HIP benefits. health information, we will treat all of that information as protected health HIP Basic does not include vision or dental coverage for members 21 and older. You can also call MDwise customer service at 800.356.1204. As nouns the difference between hip and hep is that hip is the outward-projecting parts of the pelvis and top of the femur and the overlying tissue while hep is a hip of a rose; a rosehip. We can mail you a list of these common services and their estimated reimbursement rates. HIP Basic can be more expensive that HIP Plus. HIP is offered by the state of Indiana. In contrast, POWER Accounts are administered by the managed care plans. At the end of 2008, 37,568 adults were enrolled in HIP. 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. Carol Irvin, Healthy Indiana Plan: The First Two Years. MDWise is an established Medicaid plan in Indiana that has partnered with AmeriChoice to provide HIP coverage. Call a registered nurse (RN) to talk in private about your health anytime, day or night. How do I find a provider? MDwise is an Indiana-based, nonprofit health plan. You can only choose and change your doctor by talking with MDwise. If you make your Fast Track payment or first POWER account contribution in July then your HIP Plus coverage will begin July 1. Members who meet any of the following criteria will be enrolled in HIP State Plan. 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. 2023 Call MDwise customer service right away and confirm your doctor. 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. Can I keep my doctor? In HIP Basic, you have to make a payment every time you receive a health care service. Dont have dental, vision, or chiropractic benefits? Need information in a different language or format? 3, http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/in/in-healthy-indiana-plan-ca.pdf, last accessed on October 18, 2013. It is okay to give it to your doctor, clinic, hospital, pharmacy, Hoosier Healthwise, Healthy Indiana Plan or MDwise customer service. A pregnant HIP member must promptly report her pregnancy. For help making your selection, call 1-877-GET-HIP-9. The only exception to this is a charge of $8 if a member goes to the hospital emergency room for a non-emergency. HIP Plus allows members to make a monthly contribution to your POWER account based on income. It is important to answer their questions to maintain HIP State Plan benefits. The Children's Health Insurance Program (CHIP) falls under the Hoosier Healthwise program. ET. These monthly contributions to your POWER Account may be as low as $1 a month. To learn more about Fast Track payments, click here. 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. HIP Maternity members will receive vision, dental, chiropractic coverage, non-emergency transportation and access to additional smoking cessation services designed specifically for pregnant women. If you do not pay your monthly contribution on time, you will be moved to HIP State Plan Basic. The CommonGround Recovery Library offers strategies and tools to help you start the recovery process and deal with daily challenges. What is the difference between HIP and Hoosier Healthwise? Call our Behavioral Health Crisis Line at 833-874-0016. 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). Centers for Medicare and Medicaid Services, Special Terms and Conditions for the Healthy Indiana Plan, pg. Eligibility and Enrollment from 2008 2012. These services will begin the first day of the month after youve reported your pregnancy to MHS and theDivision of Family Resources (DFR). 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. The MDwise member handbook has information about: You may want to know the cost of a medical service before you go to the doctor. Phone: 866-223-9974 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. The contribution that will be one of five affordable amounts between $1 and $20. 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. Hoosier Healthwise (HHW) is one of the Indiana Medicaid programs. If you need help picking the right health plan for you, call 1-877-GET-HIP-9. As a verb hip HIP Basic covers essential health benefits, but has less benefits covered (for example, fewer therapy visits). Your monthly POWER Account contribution will be based on your income. If you make the contribution in August, you will begin HIP Plus August 1. Learn more about the formula shortage and how to keep your baby safe and healthy during this time. The program covers medical care like doctor visits, prescription medicine . Hoosier Healthwise gives your child's health care provider a tool called a formulary. The Cost of Not Expanding Medicaid. 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. http://www.uptodate.com/home. HIP Plus has no copayments except for the improper use of the emergency room. October 2013. http://www.kff.org/medicaid/issue-brief/a-look-at-section-1115-medicaid-demonstration-waivers-under-the-aca-a-focus-on-childless-adults/. Healthy Indiana Plan (HIP) also rewards members for taking better care of their health. The member will continue to have a POWER account but will not be required to make payments. Similar to the original waiver, under the extension, parents will not be limited by enrollment caps or open enrollment periods, and will have the ability to enroll in HIP provided they make the required contributions (discussed below). This will help us contact you about you and your familys important health care information. Anthem Transportation Services can help you find out what transportation options are available in your area. 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.

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