The Hoosier Healthwise program provides coverage for children,
pregnant women, and low-income families. Enrollment in Hoosier
Healthwise is mandatory for aid categories that include children,
pregnant women, and low-income families and children who are
eligible for Children's Health Insurance Program (CHIP). The
specific eligibility aid category determines the benefit
The following Medicaid enrollees are excluded from mandatory
participation in Hoosier Healthwise managed care:
- Individuals in nursing homes and other institutions, such as
intermediate care facilities for the mentally retarded
- Undocumented individuals
- Individuals receiving waiver or hospice services
- Members with a spend-down
- Wards of the court and foster children
Hoosier Healthwise offers the following benefit packages.
Standard Plan - full coverage for children, low-income families
(package also covers Care Select).
Pregnancy Coverage Only - pregnancy-related, postpartum care,
family planning, pharmacy, transportation, and urgent care services
for some pregnant women.
Insurance Plan - preventive, primary, and acute care services
for qualified children under 19 years old.
(PE) - ambulatory prenatal coverage for pregnant women who are
determined "presumptively eligible" while their Hoosier Healthwise
application is processed.
Primary Medical Providers
As part of the Hoosier Healthwise enrollment process, members
select a primary medical provider (PMP) and health plan within 30
days of their initial enrollment into Hoosier Healthwise. Members
who do not make a voluntary PMP selection are assigned to a PMP and
health plan through an automated assignment process.
Auto-assignment is a federal requirement.
The following provider specialties are eligible to enroll as a
- Family practice (type 31, specialty 316)
- General practice (type 31, specialty 318)
- Internal medicine (type 31, specialty 344)
- Obstetrics/gynecology (type 31, specialty 328)
- General Pediatrics (type 31, specialty 345)
Enrolling as a Hoosier Healthwise Provider
To be reimbursed for services provided to Care Select
members, you must be enrolled with the IHCP and contracted with the
MCO to which the member belongs. After successfully enrolling in
the IHCP, contract with one or more MCO:
For more information see the following resources: