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 IHCP Eligibility Verification
Systems (EVS). EVS provides the following eligibility
information for HIP members:
- Verification of member eligibility under HIP
- The telephone number for the member's health plan to obtain
HIP does not cover pregnancy care. Members 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 Indiana Health Coverage Programs enrolled
provider to render covered services to HIP members. See the Become a Provider page on this
website. However, providers do not need an additional contract to
provide covered services for Enhanced Services Plan (ESP) HIP
members; Indiana Health Coverage Programs (IHCP) providers may
render services to any ESP HIP member.
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. Any Medicaid (IHCP) provider may
render covered services to HIP members. 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
HIP pharmacy benefits are managed by Catamaran Corporation. For
information refer to the Pharmacy Services quick link
on this website.
For more information or questions about the HIP health plans,
please contact the health plans directly. Additional information
about the HIP program is also available from the HIP website.