Working with Your Health Plan

Working with your health plan

If you are a member of the Healthy Indiana Plan, Hoosier Healthwise, or Hoosier Care Connect, you will need to choose a health plan. A health plan is a health insurance company.

CHOOSING THE RIGHT HEALTH PLAN FOR YOU

Choosing a health plan is a personal decision. While we are confident that all health plans are able to meet your needs, you may want to consider the following points when choosing a plan:

Provider networks: Each health plan includes a group of health care providers (doctors, specialists, home health care providers, pharmacies, therapists, and more). This is called a "network" of providers. For most health care services, you must use the health care providers who are in your health plan.

Primary or specialty medical providers: When you are enrolled in a managed care program, you will choose a Primary Medical Provider, often called a PMP. Your PMP will work with you and be your primary contact when making medical decisions. Your doctor will also make referrals and help you with prior authorizations for services that are not always covered by Medicaid.

If you already have a doctor or other primary or specialty medical provider, when choosing your health plan, you will want to make sure that provider is part of the health plan's network. If you do not have one, your health plan will work with you to identify one. To find out if your doctor or other primary medical provider is part of the health plan's network, you should call the help line listed below.

Locations: You may want to make sure that the plan you choose has providers that are conveniently located for you. This may mean they are near your work or your child's school, or they may be on a bus line.

Special programs: Each health plan has various educational programs and enhanced services. You may want to select the health plan that offers special disease management for a chronic condition or an educational program that applies to you. Plan summaries for each program are listed below.