Indiana's HIP program: Indiana Health Insurance for Low Income Households

The Healthy Indiana Plan (HIP) is an Indiana health insurance plan for low-income people of 19-64 years, who are not covered by Medicare and Medicaid. The Healthy Indiana Plan makes coverage available to hundreds of thousands of Indiana residents whom may not have had a health insurance option in the past. But the Healthy Indiana Plan now means more than just coverage. With the new HIP Plus, qualified Indiana residents may have better advantages and predictable monthly costs, and may be enrolled in coverage quicker. You must meet certain income level criteria as designated by the Federal Poverty Level index. The FPL amounts change annually based on inflation and other factors, so It's a good idea to keep an eye out for yearly changes.

People suffering the conditions below are considered medically frail and may receive additional benefits. The level of support depends on the severity of the condition.
Medical conditions

Cancer: includes all cancers subject to the 150 point limit

Diabetes mellitus with: peripheral vascular complications, hypersmolar coma, retinopathy, renal complications, coronary artery disease or ketoacidosis

Primary immune deficiencies: combined immune deficiency, DiGeorge syndrome, Wiskott-Aldrich syndrome, T-cell deficiency

Transplant or transplant wait list for heart, liver, lung, kidney or bone marrow

Paraplegia or quadriplegia

Cerebral vascular accidents

Lipid storage diseases: Nieman Pick disease, Tay Sach's disease, Fabry's disease

HIV, AIDS

Aplastic anemia

Blood clotting disorders, frequent blood transfusions

Amyotrophic lateral sclerosis

Cirrhosis

Cystic fibrosis

Chronic hepatitis B or hepatitis C

Muscular dystrophy

Primary pulmonary hypertension

Renal failure / end stage renal disease

CMV retinitis

Tuberculosis

Mental Health conditions

Alcohol and substance abuse

Major depression, schizophrenia, bipolar disorder or post-traumatic stress disorder

Assistance in daily life

24 hour supervision and/or direct assistance is needed to maintain safety due to confusion and/or disorientation

Turning or repositioning every two to four hours in the effort of preventing skin breakdown per medical plan of care

Assistance in eating

Assistance in transferring from bed or chair

Dressing

Bathing

Using the toilet

Walking aid or using a wheelchair

Poverty Levels

To qualify for HIP your income must be within 138% of the federal poverty levels. The 2018 federal poverty levels are below.

$12,140 for individuals

$16,460 for a family of 2

$20,780 for a family of 3

$25,100 for a family of 4

$29,420 for a family of 5

$33,740 for a family of 6

$38,060 for a family of 7

$42,380 for a family of 8

Qualify?

Don't Qualify?

So using the amounts above you can see that the poverty level for a 2 person household is $16,460. 138% of 16,460 is $22,411. So in order for your household to qualify for HIP you need to have a household income (the combined incomes of everyone in your household) below $22,411.

Power Accounts

If you are able-bodied but would want to be covered by HIP, you must make a monthly contribution into a POWER account. The amount of contribution varies as per your designated poverty level. Married couples are allowed to split the contributions. Contributions for spouses are 50% of the primary insureds cost or $1.00 whichever is greater. The contributions are as follows for non-smokers (smokers may have a 50% surcharge):

FPL
Under 22%
23-50%
51-75%
76-100%
101-138%

Cost
$1.00
5.00
10.00
15.00
20.00

Pre-Existing Conditions

The Affordable Care Act (ACA, aka Obamacare) guaranteed insurance coverage for pre-existing conditions. If you are in any income bracket, you can work with Indyhealthagent.com to get the best in Indiana health insurance options including HIP and Obamacare. Both HIP and ACA plans cover pre-existing conditions at no extra cost to the consumer. So no matter what your current health status is you can rest assured that not only will you be approved, but you'll also have any needed treatment and medications covered.

What is HIP? HIP or the Healthy Indiana Plan is the state of Indiana's Medicaid program for adults. Under the Affordable Care Act (ACA) HIP 2.0 was released to provide affordable health coverage for state residents with family incomes at or below 138% of the federal poverty line (FPL).
What is Medicaid? Medicaid is a program funded by both the federal government and local state governments. The states have some say so in how their program is administered and operated but must follow certain federal guidelines in order to receive federal funding. State Medicaid programs exist for children, adults and seniors, with each program having it's own eligibility criteria and benefits.
Can my kids get HIP? No. However, those that qualify for HIP will typically have their children qualify for local children's Medicaid programs.
What if my income is just over 138% of the poverty line, is there any help for me? Yes, those with incomes 139-400% FPL will usually qualify for subsidy dollars that can be used to purchase an ACA Plan.
I'm married. My spouse works but I don't. Do we have to include his/her income? In most cases income from the whole household has to be included. You may also have to include the income of other household members, even if not related to the member(s).
Where do I apply for HIP? Go to your local Indiana FSSA office or apply online at https://secure.in.gov/fssa/

I was told that it is hard to find a dentist or optometrist on HIP, can I purchase separate dental and vision coverage? Yes, we can help you find Indiana dental and vision insurance with a large network of professionals.

Does HIP include Rx coverage? Yes, in many cases you'll receive your medications for just a few dollars.

I'm on Medicare, can I get on the Healthy Indiana Plan? No, however you may qualify for extra help. Contact us for assistance with Medicare extra help. Plan members must be 19-64 years of age.

I received a letter from a carrier asking me to make a payment for my HIP coverage, does this mean I was approved? In most cases the answer is no. When applying for HIP approved Indiana health insurance carriers are allowed to collect a payment upfront to "fast track" your coverage. If approved this will allow you to receive your HIP ID card and plan materials sooner.

I forgot to turn in paperwork that Indiana FSSA / Medicaid requested and now they are canceling my policy, what do I do now? In most cases you can appeal an FSSA decision If this fails you can purchase an Indiana health insurance short term policy until the next enrollment period.

When can my coverage start? Coverage will begin the 1st of the month once a person has paid their contribution payment.

Where can I find a list of doctors that take the Healthy Indiana Plan? HIP coverage is offered through several independent Indiana health insurance carriers. Every carrier has their own network of doctors and hospitals that you can use. Below are links to each health insurance carriers network listings.
DOCTOR & HOSPITAL NETWORKS:
For Anthem: HIP Network

For MDWise: HIP Network
For MHS/Ambetter: HIP Network
For CareSource: HIP Network