Healthy Indiana Plan (HIP)
The Healthy Indiana Plan (HIP) is an affordable health plan for low-income adult Hoosiers between the ages of 19 and 64. It’s 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 health care for mental health and substance abuse, doctor care, prescriptions, and diagnostic care.
Important changes to the Healthy Indiana Plan
Understanding your options
Am I eligible?
You could be eligible if:
You could be eligible if:
- Your household income is up to 100% of the FPL.
How much do I pay?
- No copays, except for non-emergent ER visits.
- $1-$20 a month based on your income.
- If you use tobacco, you may have a Tobacco Surcharge.
- Copays for most services.
- No POWER Account contributions.
What are the benefits?
- All medical and behavioral health benefits.
- Maternal services.
- Dental services.
- Vision care.
- Chiropractic care.
- Full drug benefits.
- All medical and behavioral health benefits, including maternal services.
- Limited drug benefits.
What you receive with HIP
We’re proud to offer these benefits to keep you healthy. And with Anthem, you may qualify for more!
Full range of healthcare services
- Doctor care
- Hospital services
- Emergency and urgent care
- Lab tests and X-rays
- Medical supplies
- Behavioral health
- Prescription drugs
- Smoking cessation
See the HIP member handbook for more details.
Each year, HIP Plus members get:
• Two exams and cleanings.
• Four bitewing X-rays.
• Up to four extractions and basic restorations such as fillings.
• One crown.
HIP Basic members do not get dental care, except for HIP Basic members who are pregnant or age 19 or 20.
See your member handbook for more details.
For help finding a dentist in your area
Call DentaQuest toll free at 1-888-291-3762 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 ages 19 - 20
- HIP State Plan Plus
- HIP State Plan Basic
- HIP Maternity
- 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.
Eyeglasses (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 health care.Learn about POWER Accounts
HIP Plus members are eligible for chiropractic (back) care:
- Six spinal therapy visits each year
- Referrals from your doctor are not needed
- Preapproval from Anthem is not required
Your benefits include a wide range of prescription and many over-the-counter (OTC) drugs. We work with IngenioRx 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
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
As soon as you know you’re pregnant:
- Call Member Services toll free at 1-866-408-6131 (TTY 711).
- See your doctor for prenatal care — this is the care you receive while you’re 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’re pregnant.
After Pregnancy care
Call us at the end of your pregnancy to let us know that you have delivered. At this time, your extra pregnancy benefits will continue for another 60-day postpartum period. During this period, you will continue to have no copayments or POWER Account contributions.
After the 60-day period, you will transfer to HIP Basic. 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.Learn about healthy pregnancy
On top of your regular HIP benefits, you 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:
- Hypoallergenic bedding or air filters with a referral from your provider or case manager
- No-cost pregnancy tests
For these extras, call Member Services at 866-408-6131 (TTY 711):
- High-school equivalency assistance covers the costs of the high-school equivalency test.
- Job and skills training with our Jump Start Program offering online learning and job search tool.
- WW® (formerly Weight Watchers) covers up to four months of membership*
- Gym membership or home fitness kit offered by Active & Fit*
- Home-delivered meals for up to five days after your hospital visit
- Youth and adult hygiene kits
- Magazine subscriptions to Parents and EatingWell
Others you can access directly:
- Non-emergency transportation call 844-772-6632 (TTY 888-238-9816)
- Extra minutes for SafeLink smartphone. Visit checklifeline.org to see if you qualify, then apply for SafeLink Wireless at safelinkwireless.com or call 877-631-2550
- Community Resource Link online at anthem.com/inmedicaid under the Support tab and choose Community Support
*HIP Plus members only.
SafeLink Wireless® is a LifeLine supported services, a government benefit program.
©2020 WW International, Inc. All rights reserved.
Limitations and restrictions apply. Benefits may change.
You can redeem some benefits online through your secure account. 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!
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 preapproval. (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.
Some services require a preapproval or 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 preapproval will take no more than seven calendar days or, if urgent, no more than three calendar days.
These are types of services, if offered in your health plan, that need preapproval:
- Air ambulance
- Certain behavioral health services
- Drug injections
- 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
- Vision services
Your PMP will know which services need preapproval. We may not approve payment for a service you or your doctor asks for. If your case doesn’t meet the rules for medically needed, 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 at 1-866-408-6131 (Hoosier Healthwise, Healthy Indiana Plan); 1-844-284-1797 (Hoosier Care Connect); TTY 711.
Get the most out of your health care
We know everyone’s health is different, so we offer services that keep you in mind. Through our Integrated Medical Management Model approach, we analyze information you give us, claims data, as well as an ongoing review of your health to find a care plan to fit you and your family. We also work side-by-side by your doctor, so the care meets your physical, behavioral and social needs.
Key member resources
- HIP Member Handbook - English
- HIP Member Handbook - 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
Team up with the Indianapolis Colts!
Do you have your Blue Ticket to Health? Anthem Blue Cross and Blue Shield and the Indianapolis Colts are teaming up to help you stay healthy through the Blue Ticket to Health program. Call your doctor to schedule a wellness checkup today and enter to win!
Get your flu shot
Flu shots, pneumonia shots, FluMistTM and antiviral medications are approved benefits under most health plans. For specific information, check your member handbook or call the number on your ID card.
Make your HIP payments with MoneyGram!
To help make it easier for you to pay your POWER Account contributions, Anthem has partnered with MoneyGram. Find out more.
Page Last Updated: 6/4/21