About the Plan
Who Is Covered?
HIP is for uninsured Hoosier adults between the ages of 19-64. Parents or caretaker relatives of children in the Hoosier Healthwise program are likely candidates for HIP.
Eligibility Requirements:
- Individuals must earn less than 200% of the federal poverty level (FPL). A single adult earning no more than $21,660 a year, or families of four earning approximately $44,000 likely meet the basic financial requirements.
- Individuals must not have access to employer sponsored health insurance coverage, whether or not it is utilized by the individual.
- Individuals must be uninsured for the previous six months.
Plan Structure
The Plan provides:
- A POWER Account valued at $1,100 per adult to pay for medical costs. Contributions to the account are made by the state and each participant (on a sliding scale based on ability to pay). No participant will pay more than 5% of his/her gross family income on the plan.
- A basic commercial benefits package once annual medical costs exceed $1,100.
- Coverage for free preventive services including annual exams, smoking cessation, and mammograms.
Why a POWER Account?
- POWER Accounts give participants a financial incentive to adopt healthy behaviors that keep them out of the doctor's office. When they do seek health care, plan participants will seek price transparency so they can make value conscious decisions to better manage the funds in their account.
What Is Covered
- Services include: physician services, prescriptions, diagnostic exams, home health services, outpatient hospital, inpatient hospital, hospice, preventive services, family planning, and case and disease management
- Mental health coverage is similar to coverage for physical health, and includes substance abuse treatment, inpatient, outpatient, and drugs
Other Plan Specifics
- Sliding scale for individual contributions (based on % of gross family income):
- 0-100% FPL: 2%
- 100%-125% FPL: 3%
- 125%-150% FPL: 4%
- 150%-200% FPL: 4.5%- 5%*
* Caretaker relatives/ parental adults in this income bracket contribute 4.5%, and the childless adults contribute 5%.
- No co-pays except for ER use, which are based on a sliding scale and will never exceed $25 a visit.
- If all age and gender appropriate preventive services are completed, all (state and individual) remaining POWER Account funds will rollover to offset the following year’s contribution. If preventive services are not completed, only the individual’s prorated contribution (not the State’s) to the account rolls over.
