Each state develops a state plan, which is a comprehensive
written commitment by a Medicaid agency to administer or supervise
the administration of a Medicaid program, in accordance with
federal and state requirements. The Indiana requirements are
contained in the Indiana Code (IC) and the Indiana
Administrative Code (IAC). States may elect to administer the
Medicaid program themselves or enter into contractual agreements
with outside entities to administer the program.
The Indiana Family and Social Services Administration (FSSA)
through the Office of Medicaid Policy and Planning (OMPP) and other
divisions administer the Indiana Health Coverage Programs (IHCP),
including the health plan programs.
The FSSA has the final responsibility for all program policies
and coordinates with other state and federal agencies as
The State of Indiana has contractual agreements with the
following entities to support and administer the health plan
component of the IHCP:
- Fiscal agent
- Surveillance and Utilization Review Contractor
- Enrollment broker
- Managed care entities (MCEs)
- Monitoring contractor
- Care management organizations (CMOs)
- Healthy Indiana Plan (HIP) insurers
- Pharmacy Benefits Manager
The State of Indiana has developed the following health plan
The state of Indiana has a disease management program, Care
Select, to serve the aged, blind, and disabled; members
receiving adoption assistance; wards of the court, and current and
former foster children. Care Select is managed by the
care management organizations (CMOs).
To learn more about this program, please visit the Care Select page on this
The FSSA, under a federally approved Section 1915(b)
waiver, implemented a mandatory managed care program known as
Hoosier Healthwise - Risk-Based Managed Care (RBMC), covering
low-income families, children, and pregnant women. The program is
managed by the state's contracted managed care entities (MCEs).
To learn more about this program, please visit the Hoosier Healthwise page on this
Healthy Indiana Plan (HIP)
The Healthy Indiana Plan (HIP) is a program sponsored by the
state of Indiana to provide a more affordable healthcare choice to
thousands of otherwise uninsured individuals throughout Indiana.
HIP provides health insurance for uninsured low-income Hoosiers
between the ages of 19 and 64 who are not otherwise eligible
for Medicaid. Unlike many other government-sponsored programs,
parents and childless adults can participate. Participants are
required to make monthly contributions toward coverage.
To learn more about this program, please visit the Healthy Indiana Plan page
on this website.
The IHCP includes two authorized processes by which individuals
can be determined presumptively eligible and receive temporary
health coverage while their application and determination process
for full Hoosier Healthwise coverage is completed by the FFSA -
Presumptive Eligibility for Pregnant Women and Hospital Presumptive
To learn more about these processes, visit the Presumptive
Eligibility page on this website.
To learn more about the managed care programs, please follow
these links to other pages on this website:
We would like to know about your experience with our health plan
site. Please tell us what you