Managed Care

The Indiana Family and Social Services Administration (FSSA) administers the Indiana Health Coverage Programs (IHCP), including the managed care health plan programs.

The FSSA has the final responsibility for all program policies and coordinates with other state and federal agencies as required. The FSSA has contractual agreements with the following entities to support and administer the managed care component of the IHCP:

  • Fiscal agent
  • Surveillance and Utilization Review contractor
  • Enrollment broker
  • Managed care entities (MCEs)
  • Monitoring contractor
  • Pharmacy Benefits Manager
  • Program for all-inclusive care to the elderly (PACE) organizations

The IHCP includes the following managed care health plan programs.

Healthy Indiana Plan (HIP)

The Healthy Indiana Plan (HIP) program provides affordable healthcare coverage to low-income nondisabled adults between ages 19 and 64. HIP members have cost-sharing obligations through monthly contributions to Personal Wellness and Responsibility (POWER) Accounts or through copayment obligations. This program is managed by the State's contracted MCEs.

To learn more about this program, please visit the Healthy Indiana Plan page.

Hoosier Care Connect

The Hoosier Care Connect program is designed to improve the quality of care and clinical outcomes for IHCP members who are age 65 or older, blind, or disabled.

Hoosier Care Connect provides full Medicaid benefits, care coordination services, and other FSSA-approved enhanced benefits and is managed by the State's contracted MCEs.

To learn more about this program, please visit the Hoosier Care Connect page on this site.

Hoosier Healthwise

Hoosier Healthwise primarily covers children in low-income families. The program is managed by the State's contracted MCEs.

To learn more about this program, please visit the Hoosier Healthwise page on this site.

Program for All-inclusive Care to the Elderly (PACE)

The Program for All-Inclusive Care to the Elderly (PACE) is a Medicare and Medicaid program that helps people meet their healthcare needs in the community instead of entering a nursing home or other care facility. PACE organizations provide care and services in the home, the community, and the PACE center.

To qualify for PACE, IHCP members must be:

  • Fifty-five years old or older
  • Certified by their state to need nursing home care
  • Able to live safely in the community at the time of enrollment
  • Living in a PACE service area

To learn more about this program, visit the PACE page on this website.

Presumptive Eligibility

The IHCP includes a presumptive eligibility process through which individuals can be determined presumptively eligible and receive temporary healthcare coverage while their full IHCP applications are considered and eligibility determined. Pregnant women and certain low-income adults who are determined presumptively eligible would be enrolled with State-contracted MCEs for this temporary coverage. To learn more about this process, visit the Presumptive Eligibility page on this website.

Associated Links

To learn more about the managed care programs, please follow these links to other pages on this website: