what is the difference between hip and hoosier healthwise?

States could also see additional savings and broader economic benefits from the increases in coverage and federal financing.18 Under the waiver renewal, Indiana is not eligible for enhanced federal matching funds and continues to receive the states regular match rate for adults covered under the waiver. Anthem Transportation Services can help you find out what transportation options are available in your area. 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. health information, we will treat all of that information as protected health The only exception to this is a charge of $8 if a member goes to the hospital emergency room for a non-emergency. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. Address: 535 Diehl Road, Suite 100, Naperville, IL 60563. Fax: 866-297-3112 These HIP State Plan benefits will continue as long as your health condition, disorder or disability status continues to qualify you as medically frail. Call CareSource Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711) if you have any questions about your benefits. Unlike HIP Plus, HIP Basic has more limited options for getting medication. If you are not found eligible for HIP and you have made a Fast Track payment, this payment will be refunded to you by the MCE (Anthem, Caresource, MDwise or MHS) that took the payment. The following table shows these amounts. Members receive monthly statements that show how much money is remaining in the POWER account. If you do not make a Fast Track payment, you may face a delay in the start of your coverage. When a member makes a POWER account payment, they become enrolled in HIP Plus, which offers better health coverage, including vision, dental and chiropractic benefits. A portion of enrollees do not contribute to POWER accounts and the state pays the full amount. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. On September 3, 2013, Indiana obtained a one-year waiver extension from the Centers for Medicare and Medicaid Services (CMS) with some amendments primarily related to who is eligible for coverage. In teenagers and young adults, hip dysplasia can cause painful complications such as osteoarthritis or a hip labral tear. You will need Adobe Reader to open PDFs on this site. A pregnant HIP member must promptly report her pregnancy. As such, the 2013 waiver extension will decrease HIP eligibility levels from 200% FPL to 100% FPL for both parents and childless adults on April 30, 2014.8 For current HIP enrollees and childless adults on the waitlist, Indiana has a plan to transition those who have incomes between 100% and 200% FPL to Marketplace coverage. If your annual health care expenses are more than $2,500, the first $2,500 is covered by your POWER account, and expenses for additional health services are fully covered at no additional cost to you. Your benefit year will be a calendar year running January to December. You can also have the amount of your reduction doubled if you complete preventive services. between the HIP 2.0 program and the Hoosier Healthwise (HHW) program has resulted in unequal access to health care services, in accordance with Section IX.8.a of the HIP 2.0 Special Terms and Conditions (STCs). McLaren Health Care and/or its related entity, Commitment to Quality Care | Healthy Indiana Plan, Find a Drug | Healthy Indiana Plan State Plans, Benefits and Services | Hoosier Healthwise, Affordable Connectivity Program | Hoosier Healthwise, Commitment to Quality Care | Hoosier Healthwise, Getting Help with a Problem | Hoosier Healthwise, Renewing Your Coverage | Hoosier Healthwise, Nondiscrimination/Accessibility (English), Nondiscrimination/Accessibility (Spanish). CMS guidance specifies that states will not be eligible for enhanced matching funds from the ACA if there is a cap on enrollment or a partial expansion. Ensure state fiscal responsibility and efficient management of the program. It is the State of Indiana's health care program for children, pregnant women, and families with low income. First, the individual has the . CMS has recently issued new regulations related to cost-sharing and it is not clear if they will grant waivers of these limits that would be eligible for enhanced matching funds.16. Your eligibility year will remain unique to you. With HIP Plus you can get 90 day refills on prescriptions you take every day and can receive medication by mail order. Since the ACA expands Medicaid to adults with significant federal funding, the need for and role of waivers fundamentally changes. The contribution that will be one of five affordable amounts between $1 and $20. Please review it carefully. If you are an enrolled HIP member, you should call your health plan (Anthem, CareSource, MDwise or MHS) or go online to their website to research which providers are in that health plan's network. New members get 90 days to decide if they want to stay in the MDwise plan. Once a member is approved for HIP, he or she will be assigned to the health plan selected on the application. There are multiple Indiana Medicaid health plans. HIP Basic members do not have a simple, predictable monthly contribution. HIP Basic is the plan for HIP members who do not make their monthly Personal Wellness andResponsibility(POWER) Account contributionsfor more than60 days.HIP Basic . This helps him or her prescribe drugs for you. the unsubscribe link in the e-mail. The state of Indiana pays for most of the $2,500 in the POWER account, but the member is responsible for a fixed monthly payment depending on income. Click hereto learn how you can earn My Health Pays rewards. 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. Opens in a new window. 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. In HIP Basic, you have to make a payment every time you receive a health care service. Healthy Indiana Plan (HIP) | Anthem BlueCross BlueShield Indiana Medicaid For example if your POWER account contribution is $4, then your first two months of coverage will be paid in full, you will owe a balance of $2 in the third month, and then $4 for every following month to maintain HIP Plus enrollment. HIP Plus has comprehensive benefits including vision, dental and chiropractic services. HIP Basic does not include vision or dental coverage for members 21 and older. Based on family income, children up to age 19 may be eligible for coverage. The Healthy Indiana Plan is the state of Indianas signature, consumer-driven health coverage program for non-disabled Hoosiers ages 19-64. Hoosier Healthwise (HHW) is one of the Indiana Medicaid programs. HIP Basic benefits also allow fewer visits to physical, speech and occupational therapists. HIP State Plan Basic offers enhanced benefits such as vision, dental, chiropractic and transportation services. We can mail you a list of these common services and their estimated reimbursement rates. The Healthy Indiana Plan (HIP) is an affordable health plan for low-income adult Hoosiers between the ages of 19 and 64. From the date you receive your initial Fast Track invoice you will have 60 days to make a payment to start your HIP Plus coverage. There are two HIP plans. Advertising revenue supports our not-for-profit mission. These monthly contributions to your POWER Account may be as low as $1 a month. If your POWER account contribution is more than $10, then you will owe the balance in the first coverage month. The precise location of your hip pain can provide valuable clues about the underlying cause. Parents below 22% were eligible for regular Medicaid before implementation of the Healthy Indiana Plan, and continue to receive regular Medicaid coverage. Need help with some of the HIP terms? Physical, mental or sexual abuse by medical staff. It's sponsored by the state and for some members requires a small monthly payment through your Personal Wellness and Responsibility (POWER) Account. You can report fraud and abuse by calling MDwise customer service. input, Family and Social Services Administration, Transferring to or from Other Health Coverage, Click here to find monthly contribution amounts, Click here for a comparison of the available health plans, Click here to see a list of conditions that may qualify you as medically frail, Report 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. Copayments for non-preferred drugs are $8. John Holahan, Matthew Buettgens, and Stan Dorn. The majority of states that have used Section 1115 waivers to expand Medicaid coverage to adults plan to implement the Medicaid expansion and transition current waiver coverage to new coverage under the ACA. The program covers medical care such as doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost to the member or the member's family.

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