Healthy Indiana Plan | Indiana Medicaid

Understanding Your Options

The Healthy Indiana Plan (HIP) is an affordable health plan for low-income adult Hoosiers between ages 19 and 64. It is sponsored by the state and for some members requires a small monthly payment through your Personal Wellness and Responsibility (POWER) Account. HIP offers full health benefits, including hospital care, behavioral healthcare for mental health and substance use, doctor care, prescriptions, and diagnostic care.

Copayment And Contribution Collections Are Currently Stopped

POWER Account Contributions and copayments remain paused for Healthy Indiana Plan (HIP) members. During this time, you will not receive POWER Account statements or invoices, and copayments will not be required for any service. We will notify you when you will need to make contributions and copayments again.

What You Receive With HIP

We’re proud to offer these benefits to help keep you healthy. And with Anthem, you may qualify for more.

Healthy Indiana Plan (HIP) benefits include:

Doctor care
Hospital services
Emergency and urgent care
Lab tests and X-rays
Medical supplies
Behavioral health
Prescription drugs
Smoking cessation
Transportation*

* HIP State Plans and HIP Maternity Plan members only.

See the HIP member handbook for more details.

HIP Plus

Each year, HIP Plus members can access:

Two oral exams and two cleanings.
One set of bitewing X-rays and one complete set of X-rays every 5 years.
Extractions and minor restorations such as fillings.
Major restorations such as crowns and root canals.

HIP Basic members do not have access to dental care. However, members who are pregnant or under age 21 can access dental care.

See the HIP member handbook for more details.

Help finding a dentist in your area

Call DentaQuest toll free at 888-291-3762 (TTY 800-466-7566) or visit DentaQuest.

DentaQuest, an independent company that does not provide Blue Cross and Blue Shield products, administers dental benefits for Anthem.

Vision benefits are available for the following HIP members

HIP Plus
HIP Basic members under age 21
HIP State Plan Plus
HIP State Plan Basic
HIP Maternity

Eye exams

One eye exam per year for members under 21 years old.
One eye exam every two years for members 21 years and older.
Additional examinations must be medically necessary.

Eyeglassses (including frames and lenses)

One pair of eyeglasses per year for members under 21 years old, unless medically necessary under EPSDT.
One pair of eyeglasses every 5 years for members 21 years and older.

For help finding an eye doctor in your area

Call Superior Vision toll free at 866-866-5641 (TTY 866-428-4833) or visit their website.

In HIP, the first $2,500 of your medical expenses are paid with a special savings account called a Personal Wellness and Responsibility (POWER) Account. The state will pay most of this amount, but if you’re a HIP Plus member, you’ll be responsible for making a small contribution to your account each month. The amount will be based on your income. If you’re a HIP Basic member, you don’t pay a contribution. After the $2,500 in your POWER Account has been spent, Anthem will begin paying for your healthcare.

Learn about POWER Accounts

HIP Maternity

If you qualify for HIP and you’re pregnant or become pregnant while you’re in HIP, you’ll be enrolled in the HIP Maternity plan. HIP Maternity members receive full comprehensive health coverage, including but not limited to:

Prenatal services
Vision, dental, medical, and chiropractic coverage
Non-emergency transportation
Behavioral health services
Substance use disorder (SUD) services
Smoking cessation services designed specifically for pregnant members

Pregnancy care

As soon as you know you are pregnant:

Call Member Services toll free at 866-408-6131 (TTY 711).
See your doctor for prenatal care. This is the care you receive while you are pregnant. Our staff will make sure your doctor and hospital are in your plan.

While you’re in the HIP Maternity plan, you have:

No copays.
No POWER Account payments while you are pregnant.

After pregnancy care

Call us to let us know your baby has been born. Your extra pregnancy benefits will continue for another 12-month postpartum period. During this period, you will continue to have no copayments or POWER Account contributions.

After the 12-month period, you will transfer to HIP Basic if eligible*. To switch to HIP Plus, you will need to make a POWER Account contribution within 60 days of receiving HIP Basic benefits. Members with income over the federal poverty level who do not pay for HIP Plus will lose eligibility for HIP Basic after 60 days.

* While cost-sharing is paused, you will transfer to HIP Plus if eligible.

On top of your regular HIP benefits, HIP Plus members can receive no-cost extras just for being our member. You can access these benefits in a few different ways.

Some extra benefits can be ordered by logging in to the secure Benefit Reward Hub. These include:

Asthma and COPD relief — select one asthma or COPD relief product from the catalog annually. 
Nonpharmacologic pain management  — members may be eligible for a product voucher towards pain management devices.
Personal care items — voucher per member per year for health and wellness products.
Transportation essentials— gas card or ride-share card (may not be combined with bus passes).

For these extras, call Member Services at 866-408-6131 (TTY 711):

Healthy Adults, Healthy Results – get access to online on-demand fitness and exercise videos, a home fitness kit, and gym membership for six months. Additionally, receive a WW voucher for 13 weeks of membership fees.
Healthy meals — healthy meals delivered to your doorstep.
Fresh fruits & veggies program – produce box delivered to your home for pregnant or nursing members up to six weeks postpartum.
High School Equivalency (HSE) assistance — covers the costs of the high-school equivalency test.
Essentials for expectant parents — online learning courses on pregnancy and new baby care, plus items to keep parent and baby comfortable and safe.
Employment Concierge - receive personalized support from our member concierge to connect with resources and opportunities for employment, upskilling, and job readiness.
Smartphone Member Connect – support and guidance in getting smartphone services to stay in touch with family, friends, doctors, and social services. Call Member Services to learn more.

Others you can access directly:

ChooseHealthy – online exercise and fitness resources
Community Resource Link — Find help in your community with food, jobs, housing, and other things you may need.

You can redeem some benefits online through your secure account. You may need to complete activities like an online health screening or yearly wellness or dental visit to be eligible for certain extras. View the extra benefits you are eligible for on the Benefit Reward Hub or call the Member Services number on the back of your member ID card. Log in to get started today.

Referral

A referral is when your primary medical provider (PMP) sends you to another provider for care.

This care is often from a specialist. Your PMP may send you to a specialist for special care or treatment. Your PMP can:

Help choose a specialist to give you the care you need.
Help you set the day and time for the office visit with a specialist.
Ask Anthem is if you can get services from a specialist. Your PMP knows when to ask for a prior authorization. (See below.)

Some types of services are known as self-referral services. That means you can get these services without a referral from your PMP. You can see any Indiana Health Coverage Programs (IHCP) doctor for many of these services. See your member handbook for a list of these services.

Prior authorization

Some services require a prior authorization, or an OK, from Anthem. Your PMP will ask Anthem to make sure they’re offered. If they are, both Anthem and your PMP or specialist agree the services are medically necessary.

Getting a prior authorization will take no more than five business days or, if urgent, no more than 48 hours

These are types of services, if offered in your health plan, that need prior authorization:

Air ambulance
Certain behavioral health services
Biofeedback
Drug injections
Certain dental services
Some equipment
Genetic testing
Home health and hospice care
Hyperbaric oxygen therapy
Infusion therapy and chemotherapy
Inpatient hospital services
Certain laboratory tests
Services not in your plan
Referrals to specialists
Radiology services
Select outpatient surgeries/procedures
Sensory integration therapy
Transplant services
Certain vision services

Your PMP will know which services need prior authorization. We may not approve payment for a service you or your doctor asks for. If your case doesn’t meet the rules for medically necessary, we’ll send you a letter. The letter will tell you we could not approve the service and why. The letter will also let you know how to appeal our decision if you disagree with it. For more help, please call Member Services for Healthy Indiana Plan at 844-284-1797 (TTY 711).

Changing Health Plans

You can switch to a different health plan if you want to. You can do so in one of these two ways:

When you first enroll in HIP and before paying your first POWER Account contribution — unless you have a previous health plan already assigned for the current calendar year.
During the health plan selection period each year from November 1 to December 15.

All other health plan changes must be made for just cause. To find out more about changing health plans, contact the Enrollment Broker by calling 877-GET-HIP-9 (877-438-4479) or review your member handbook.

Not sure if you qualify?

Find out here

HIP Plus

You could be eligible if:

Your household income is up to 138% of the federal poverty level (FPL).
You pay your monthly POWER Account on time.

HIP Basic

You could be eligible if:

Your household income is up to 100% of the federal poverty level (FPL).

HIP Plus

You get:

All medical and behavioral health benefits
Maternal services.
Dental services.
Vision care.
Chiropractic care.
Full drug benefits.

Learn more about HIP Plus

HIP Basic

You get:

All medical and behavioral health benefits, including maternal services.
Limited drug benefits.

Learn more about HIP Basic

The Member Handbook: Everything You Need To Know

Your member handbook is your go-to guide for health services. Read it to find out about:

How to use your benefits.

How to choose a primary medical provider (PMP).

How to get help if your doctor’s office is closed.

How to reach Member Services if you have questions.

Your rights and responsibilities as a Anthem member.

And more.

HIP Member Handbook (English)

HIP Member Handbook (Spanish)

Key Member Resources

HIP Preapproval Member Handbook Update - English

HIP Preapproval Member Handbook Update - Spanish

HIP Member Handbook Pharmacy Update - English

HIP Member Handbook Pharmacy Update - Spanish

HIP Waiver MCE Selection Letter - English

HIP Waiver MCE Selection Letter - Spanish

IN HIP Quick Start Guide - English

IN HIP Quick Start Guide - Spanish

Need A Handbook Mailed To You?

You can request a handbook via live chat with Member Services.

Welcome New Members To Anthem

We’re happy you’re here. As a new member here are some resources to help you get started. Be sure to check out our new member page for more information.

New Member Welcome Flyer - English

New Member Welcome Flyer - Spanish

New Member Welcome Letter - English

New Member Welcome Letter - Spanish

PMP Selection Form - English

PMP Selection Form - Spanish

ACH Form - English

ACH Form - Spanish

Employer and Third-Party Contribution POWER Account Flyer- English

Employer and Third-Party Contribution POWER Account Flyer - Spanish

Find more member resource

Team Up With The Indianapolis Colts

Do you have your Blue Ticket to Health?

Anthem and the Indianapolis Colts are teaming up to help you stay healthy through the Blue Ticket to Health program. Click the link to learn how you can enter for a chance to win one of many prizes.

Learn more about Blue Ticket to Health