Healthy Indiana Plan (HIP)

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The Healthy Indiana Plan (HIP) is a program offered by the state of Indiana that makes low-cost health insurance available to low income Indiana residents.

When can I get HIP coverage?

· If you are between 19 and 64 years old, do not have access to employer sponsored coverage, have been uninsured for at least 6 months, and earn up to 200% FPL, you may be able to buy health insurance through HPI. Individuals who meet all the eligibility requirements but are above 200% FPL, may be able to buy HIP coverage at full cost.

As of July 2009, there is a waiting list for HIP coverage for childless adults.

· Individuals with COBRA, accident only policies and disease specific policies are not subject to the 6 month uninsured requirement. In addition, if you are only eligible for employer sponsored coverage as a dependent on your spouse’s coverage, you are not considered to have access to employer sponsored coverage and may be eligible for HIP.

What will HIP cover?

· HPI provides comprehensive coverage to eligible individuals. Coverage includes physician services, hospital, prescription drugs, X-rays, and mental health services. Vision, dental and pregnancy are not covered benefits. All individuals are subject to a $300,000 annual cap and a $1 million lifetime cap. Currently, Anthem and MDWise with AmeriChoice are participating in HIP.

· Some individuals may be eligible for benefits through the HIP Enhanced Services Plan. The state may determine that HIP enrollees with certain health conditions are eligible for the HIP Enhanced Services Plan, which provides benefits through the Indiana Comprehensive Health Insurance Association (ICHIA).

What about pre-existing conditions?

· There are no pre-existing condition exclusion periods when you buy health insurance through HIP.

What can I be charged for HIP coverage?

· You may be required to contribute up to 5% of your household income towards the premiums, depending on your household size and income. The state will contribute the remaining premiums. In addition, individuals may be responsible for co-payments for emergency room visits.

· For more information about HIP, the Family and Social Services Administration, Healthy Indiana Plan at (877) 438-4479 or visit them on the web at http://www.in.gov/fssa/hip/.


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