Provider Information

The Healthy Indiana Plan program provides affordable healthcare coverage to low-income nondisabled adults between the ages of 19 and 64. The HIP program offers four distinct plans:

• HIP Plus - HIP Plus members receive a full commercial benefit package that includes coverage for vision, dental, and chiropractic services.
• HIP Basic - HIP Basic members have a more limited benefit plan and most are assessed copayments for most services.
• HIP State Plan - The HIP State Plan provides “medically frail” members access to comprehensive Indiana Medicaid State Plan services and includes cost-sharing responsibilities through POWER account contributions (HIP State Plan - Plus) or copayments (HIP State Plan - Basic), as determined by a member's eligibility category and income level.
• HIP Maternity – HIP Maternity members receive a full-coverage benefit package throughout their pregnancy and for 12 months post-partum. There are no required financial contributions or copayments. This plan has enhanced benefits, such as transportation to medical benefits.

The HIP program is operated within the managed care delivery system. In this delivery system, contracted managed care entities arrange, administer, and pay for the delivery of healthcare services to members enrolled in their health plan. The following four MCEs are contracted with the state of Indiana to serve the HIP population:

• Anthem
• CareSource Indiana
• Managed Health Services
• MDwise

The care of HIP members enrolled with the MCE is managed through its network of primary medical providers, specialists, and other providers that contract directly with the MCE. To be reimbursed for services provided to HIP members, providers must be enrolled with the IHCP. (See the "Become a provider" web page.) After successfully enrolling in the IHCP, a provider can contract with one or more of the MCEs to serve their enrolling members. Reimbursement for all services, except Medicaid Rehabilitation Option services, is provided through the MCEs. This includes dental and pharmacy services.

For more information or questions about the HIP health plans, contact the MCEs directly. See the IHCP quick reference guide for contact information.

Additional resources

• Healthy Indiana Plan provider reference module
• IHCP provider news, banners and bulletins
• HIP forms
• Helpful tools
• Model POWER account payment consent form
• Training session/webinar for stakeholders and navigators on February 16
• Navigator checklist for member enrollment