Healthy Indiana Plan (HIP)
The Healthy Indiana Plan (HIP) is a program sponsored by the
state of Indiana that provides a more affordable healthcare choice
to thousands of otherwise uninsured individuals throughout Indiana.
HIP provides health insurance for uninsured adult Hoosiers between
the ages of 19 and 64 whose incomes are up to 200% of the federal
poverty level (FPL), and who are not otherwise eligible for
Medicaid. Unlike many other government-sponsored programs, parents
and childless adults can participate. Eligible participants must be
uninsured for at least six months and cannot have access to
employer-sponsored health insurance. Participants are required to
make monthly contributions toward coverage.
HIP members are given member ID cards through the health
insurance plans once their coverage is effective. Although HIP
eligibility information is available through the plans, and the
plans are the best source to check eligibility and covered services
or prior authorizations, limited information is also available in
the Indiana Health Coverage Programs (IHCP) Eligibility Verification Systems
(EVS). EVS provides the following eligibility information for HIP
- Verification of member eligibility under HIP
- The telephone number for the member's health plan to obtain
HIP does not cover pregnancy care. Members who become pregnant
must fill out a Report of Change in
Child/Family Status form and submit proof of pregnancy to
become eligible for Hoosier Healthwise.
Providers must be contracted with a HIP Plan in addition to
being an IHCP-enrolled provider to be reimbursed for covered
services rendered to most HIP members. (See the Become a Provider
page on this website.) Providers do not, however, need an
additional plan contract to be reimbursed for covered services
rendered to Enhanced Services Plan (ESP) HIP members. All active
IHCP providers may render services to ESP HIP members.
Enhanced Services Plan
The Enhanced Services Plan (ESP) is a special plan for some HIP
enrollees with certain high-risk medical conditions. Applicants are
screened for complex medical conditions such as cancer, HIV/AIDS,
hemophilia, transplants, and aplastic anemia. ESP provides all HIP
benefits, in addition to comprehensive disease management
ESP is administered by the Indiana Comprehensive Health
Insurance Association (ICHIA) through Xerox. Xerox processes
medical claims and coordinates member services for ESP, and also
coordinates case management. Catamaran Corporation processes
pharmacy claims. ESP providers are not required to have a contract
with ESP or ICHIA.
The following health plans are contracted with the state of
Indiana to serve the Healthy Indiana Plan population:
Healthy Indiana Plan Insurers
HIP Enhanced Services Plan Insurers
For more information or questions about the Healthy Indiana Plan
insurers, please contact them directly. See the IHCP Quick Reference Guide for contact
For Healthy Indiana Plan forms see the Forms page of this
HIP pharmacy benefits are managed by Catamaran Corporation. For
pharmacy information, see the Pharmacy Services
quick link on this website.
Additional information about the HIP program is also available
in Chapter 2 of the IHCP
Provider Manual and on the HIP website.