Healthy Indiana Plan (HIP) benefits

Your benefits include a wide range of prescription and over-the-counter (OTC) drugs. We work with CarelonRx to provide these pharmacy benefits.

Visit the pharmacy page to find a pharmacy near you and check if your medicine is covered.

Go to the Pharmacy page 

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.

©2020 WW International, Inc. All rights reserved. Limitations and restrictions apply. Benefits may change.

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 866-408-6131 (TTY 711).