There are 4 different kinds of Healthy Indiana Plan. How does one apply and make sure they are covered? This info graphic has been helpful to many in our small community. Adjustments may be needed for other counties in Indiana.

1.  H O W I T W O R K S
 W H A T I T P A Y S F O R
 H O W T O G E T I T
 W H O T O C A L L F O R H E L P
Healthy Indiana Plan
K R I S R O E H L I N G
C O M M U N I T Y H E A L T H W O R K E R
D E C E M B E R 2 0 1 5

2. 4 Kinds of HIP Benefits
1. HIP 2.0 Basic
2. HIP 2.0 Plus
3. HIP State Plus
4. HIP State Basic
1. HIP 2.0 Basic:
A. EHB
2. HIP 2.0 Plus:
A. EHB
B. Vision, Dental (limited)
3. HIP State Basic and
HIP State Plus
A. EHB
B. Vision, Dental
C. Medicaid Rehab Option (MRO)

3. HIP 2.0 HIP State
Plus: Power Account Contribution $1 - $30 | Co-Pay $0
Basic: Power Account Contribution $0 | Co-Pay $4
Vision
Dental
(Limited to 4
procedures / year)
Vision
Dental
Chiropractic
Medicaid
• Health Coach
• Recovery Coach
• Peer Support
• Case Manager
• Ride to doctorDoctor, Therapy
Hospital, Pharmacy
4
32
1
Essential
Health
Benefits

4. Essential Health Benefits
 Doctor Visits
 Emergency Room
 Maternity
 Labs
 Mental Health
 Pharmacy
 Preventative
 Pediatric
 Rehabilitation
 Physical
 Speech
 Occupational Hospitalization
 Surgery, Illness
 Psychiatry
 Stress, Medical Detox

5. MRO
Medicaid Rehab Option
 Essential Health Benefits
 Dental, Vision,
Chiropractic
 Life Skills / Case Mgt
 Health Coach
 Recovery Coach
 Case Manager
 Peer Support Specialist
 Non Medical Transport
 Medi-cab to
 Doctor
 Therapy
 Coach / Case Manager

6. HIP 2.0 HIP State
Plus: Power Account Contribution $1 - $30 | Co-Pay $0
Basic: Power Account Contribution $0 | Co-Pay $4
Vision
Dental
(Limited to 4
procedures / year)
Vision
Dental
Chiropractic
Medicaid
• Health Coach
• Recovery Coach
• Peer Support
• Case Manager
• Ride to doctorDoctor, Therapy
Hospital, Pharmacy
4
32
1
Essential
Health
Benefits

7. How to get HIP Plus
Hospital
Presumptive
Eligibility
HIP 2.0
Basic
Hospital
Or
Centerstone
Apply for Health Coverage www.hip.in.gov
Letter: Conditional Approval or Denial (1 Month)
Invoice and 1st Payment (1 Month)
Payment is Processed (2 Weeks)
Coverage is Retro-Active to 1st of Month
Insurance Card
Schedule Appointment
Doc Appt (1-2 Months)

8. How to get HIP State
1. Check-off all Illness
that apply to the
member on HIP
Application
Indiana determines if
Medically Frail
2. If state determines
that member is not
medically frail:
Call insurance
company to appeal
(See Slides 12, 13 & 14)

9. What Happens if…?
If.. Then…
I don’t choose an insurance company The state will assign one to you
The State asks for proof that I don’t work at a
former employer
• Get a letter from employer
• Get a letter from an organization
• Write a letter yourself
• Get a report from Work One
I don’t pay on time
The state will wait 60 days, then assign to
HIP Basic, or deny coverage
Insurance company does not receive mailed
payment
• Make a another payment but don’t mail it.
Instead, send it via debit card or money
gram
Best ways to pay:
Debit: Call Insurance, give debit card #
Money Gram:
• Get Cash, Member # and Receiver #
• Go to CVS or Walmart

10. How to Choose Insurance
Choose
Customer
Service
Benefit
Doctor
 Benefits:
 All HIP insurers are similar
 Doctor
 Does my doctor take this insurer
 Customer Service
 Access (how many Phone #’s)
 Appeal Process
 You or family has been a
member before
 Reputation with your Doctor or
Therapist
 See notes bel0w for more details

11. Helpful Phone Numbers
Who Contact What they do
FSSA 800-403-0864
• Option 1
• Option 9
Determine eligibility for programs
(HIP, Medicaid, SNAP.
Can answer questions about
eligibility dates and which MCE was
chosen.
HIP 877-GET HIP 9
877-438-4479
• 1 for English
• 1 for General Information
HIP “Insurance Brokers” they are
the central hub of information
about status of application, next
steps etc.
They can tell you someone’s
• HIP Enrollment Status
• Next steps that need to be taken
• Phone number for MCE

12. Person Number and Email What they do
Main number 800-356-1204
Status
Recipient ID (RID)
Billing 866-539-4092
Status
Recipient ID
Take a payment
Mailing Address for Pmt
Barb Shull
Medically Frail
Manager
317-822-7558
Appeal for Med. Frail
Status of Appeal
Documents needed for Appeal
Money Gram CVS, Walmart
Recipient ID (RID) / Member #
Receive code 15187
MD Wise

13. Person Contact Info What they do
Main Number 877-647-4848
Status
Recipient ID
Billing information
Michelle Werner
Medically Frail
Team
Phone:
877-647-4848
x 20691
Fax:
866-831-8203
Makes determinations for Medically
Frail Status
Make Appeal
Status of Appeal
Documents needed for Appeal
Money Gram CVS, Walmart
Invoice
Recipient ID (RID) / Member ID
Receive Code: 15200
Medical Health Services (MHS)

14. Person Contact What they do
Main Line 866-408-6131
Status of the Member
Recipient ID #
How to make payment
Accept information for Appeal
Send a form for Appeal/Grievance
Receive Debit Card Payments
1st Payment
By Mail
Anthem BCBS IN Individual
PO Box 659807
San Antonio TX 78265
Money Gram CVS, Walmart
RID / Member ID
Receive Code: 15204
Anthem Blue Cross Blue Shield

15. HIP ONLINE
W W W . H I P . I N . G O V
HIP HELPFUL TOOLS
H T T P : / / W W W . I N . G O V / F S S A / H I P / 2 4 5 4 . H T M
1-800GET HIP 9
Sources

16. C r e a t i v e C o m m o n s A t t r i b u t i o n
n o n - C o m m e r c i a l 4 . 0
I n t e r n a t i o n a l L i c e n s e
Y o u h a v e p e r m i s s i o n t o
S h a r e - c o p y , a n d r e d i s t r i b u t e i n a n y f o r m a t
A d a p t – r e m i x , t r a n s f o r m a n d b u i l d - u p o n
U n d e r t h e f o l l o w i n g t e r m s :
G i v e a p p r o p r i a t e c r e d i t
U s e o n l y f o r n o n - c o m m e r c i a l p u r p o s e s
h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y - n c / 4 . 0 /
Questions, Comments
Kris Roehling
812-340-5518
C o n t r i b u t o r s
A n d E d i t o r s
S t e p h a n i e S p a g n o l o
S c o t t S t o w e r s
D a v i d M y e r
N a n c y W o o l e r y
C h r i s M o r r i s o n
G i n a F o r r e s t
N a n c y R i c h m a n
J o H a r g e s h e i m e r
K a t h y H e w e t t

17. HIP Pays for Crisis Care
HIP does not pay for longer
Inpatient Treatment
 Most Medical Hospitals
 Stress Unit / Medical Detox
 Harm to Self or Others
 Limited to about 1 week
 Some Hospitals only accept
Anthem (as of 12/1/2015)
 Fairbanks (NE Indianapolis)
 Valle Vista (Greenwood)
 Deaconess / Stepping Stones (Evansville)
 30-day Inpatient (Free, IND)
 Recovery Matters (East Chicago)
 Life Springs (Jeffersonville)
 Long-Term Residential
(3-12 months) “Affordable”
After thought I
Inpatient Substance Abuse Treatment
https://findtreatment.samhsa.gov/
• Amethyst
• Harbor Lights
• Progress House
• Light House
• Serenity
• Bliss
• New Beginnings
• Pathways
• Others in IND
• Other States

18. After thought II
Confusing Letters
 “Congratulations, you have
been conditionally approved for
the Healthy Indiana Plan…”
 “Welcome to our Insurance
company. You will receive a
membership card and
services….”
What happens if I don’t pay on
time?
 Less than 100% of FPL:
 Insurance delayed 2 months
 Downgraded to Basic until the
following year
 More than 100% of FPL:
 Insurance denied
 Reapply - Start over
 May be locked out
for 6 months
…AFTER
You make a
payment!

19. Other Helpful Links
 Sample of Conditional Approval Letter
 http://www.findforms.com/single_form.php/form/24014/53453_pdf_Gove
rnment_Indiana
 Authorized Representative for Health Coverage
 http://www.in.gov/fssa/dfr/2689.htm
 HIP Rights and Responsibilities
(Long, text version of how it works, time limits etc.)
 file:///C:/Users/kristina.roehling/Downloads/55367.pdf