Becoming Elligible for the Healthy Indiana Plan

Member Eligibility

Eligibility in HIP is limited to uninsured Hoosiers between the ages of 19 to 64 whose family income is up to 200 percent of the federal poverty level (FPL). Other key eligibility requirements include, but not limited to:

• No access to employer-sponsored insurance
• No insurance coverage for the previous six months including Medicare
• Consolidation of Benefits in Retirement Act (COBRA) coverage is not subject to the six-month provision. If a person has exhausted COBRA benefits, they do not need to wait six months to participate in HIP
• A parent of a child enrolled in or eligible for Hoosier Healthwise will likely qualify

Eligibility Verification Systems

HIP members will be given member ID cards through the health plans. Although HIP eligibility information will be available through the plans, limited information will also be available in the IHCP Eligibility Verification Systems (EVS). EVS will provide the following eligibility information for HIP members:

• The member is eligible for HIP
• The member's insurer and telephone contact information for member's benefits

Personal Wellness Responsibility Account

The Personal Wellness Responsibility (POWER) Account is comprised of a monthly member contribution plus a State contribution. Members pay a modest monthly contribution for the HIP coverage. Contributions range from 2 percent to 5 percent of the family income based on gross income and family size. The maximum combined total amount of the POWER Account is $1,100 and is used to pay the initial eligible expenses or the deductible to participating providers. If a POWER account is not fully-funded, the plan will still be required to pay all claims.