“Healthy Families = Healthy Learning”
By: Tina Darling, MPA Program Director; Connecting Kids to Coverage-Indiana; Indiana Rural Health Association
In 2015, Indiana expanded Medicaid thereby providing a health coverage option to a particular demographic – healthy adults, ages 19-64 – that had previously been without a “safety net” plan. Just prior to the expansion, 1,120,674 people were enrolled in Indiana’s Medicaid and CHIP (Children’s Health Insurance Program) programs; by May 2020, this number had grown by 34% to 1,563,101 (Norris, 2020). While this progress toward getting eligible Hoosiers insured is impressive, Indiana still has approximately 7% of its children going without health coverage, even though these children may be eligible for it (Kaiser Family Foundation, 2020). The primary goal of the Connecting Kids to Coverage-Indiana program is to find those eligible Hoosier children, get them enrolled in Hoosier Healthwise (Indiana’s CHIP program), and help parents keep their children enrolled from year to year. Helping parents find coverage for themselves is also a program goal. Our team of licensed Indiana insurance navigators can help parents explore coverage options for themselves and their families, either through Indiana Health Coverage Programs like the Healthy Indiana Plan (Medicaid Expansion) and Hoosier Healthwise, or through Marketplace options. (Marketplace open enrollment for 2021 coverage runs from November 1 to December 15, 2020.)
Getting and keeping coverage through Indiana Health Coverage Programs (IHCPs) is not always easy. But once obtained, you will be hard pressed to find more comprehensive coverage anywhere on the open market. For children especially, Hoosier Healthwise offers outstanding comprehensive full-service coverage for children from birth up to age 19, and allows parents to choose their provider. (Unless they are already enrolled in the Healthy Indiana Plan, Hoosier Healthwise also covers pregnant women in Indiana). Depending on household size and income, families will pay little or no copays/premiums with Hoosier Healthwise. In compliance with the Affordable Care Act (ACA), all preventable services are covered, including immunizations and well-child visits. In addition, the program covers prescriptions, mental health care, dental care, hospitalizations, and surgeries. The best thing about Hoosier Healthwise – and the message we are hoping to impart to Hoosier parents – is that the monthly income eligibility requirement is very generous. For example, a family of three can earn as much as $4,752 per month (before taxes) and still qualify to have their child/children covered by Hoosier Healthwise. Too many parents assume they make too much money to qualify for this program, but this may not be the case. By working with a licensed Indiana insurance navigator, parents can receive free help in figuring this out.
The Healthy Indiana Plan (HIP Plus) for healthy adults ages 19-64 (who are not disabled or institutionalized) also offers an excellent comprehensive health coverage plan for those with incomes up to 138% of the Federal Poverty Level (FPL). For example, someone with a household family size of four people, and a monthly income of $3,049 can qualify for HIP Plus. A small monthly contribution based on income is required, and members can choose from four health plans for their coverage: Anthem, CareSource, MDWise and Managed Health Services (MHS). HIP Plus offers approved dental, vision, and chiropractic visits and services, and requires no copays for prescriptions or doctor visits. Program members can earn rewards for wellness and healthy choices, and they are offered smoking and tobacco cessation programs free of charge.
The application for both HIP Plus and Hoosier Healthwise is online, and can be completed as your time permits: in other words, you can save your application and return to it later. If you don’t have a computer, other options are available including contacting a licensed Indiana insurance navigator who can help you in person (relative to current pandemic restrictions) or by phone; calling the Indiana Department of Family Resources (DFR) at 1-800-403-0864; or by visiting your local county DFR office. To find your local office, call this same 800 number or click here. Below is a list of several places to find a licensed Indiana navigator:
Your application for coverage should be approved in anywhere from 45-90 days, sometimes less. You can check your status online or by phone, and you will receive your notification of approval or denial by US Mail. Any requests for additional information will also be sent via US Mail, so it is imperative to watch your mail, and/or inform Indiana DFR of any change in address. If you are denied coverage, you can appeal what you believe is an “adverse benefit determination,” but it must happen within 33 calendar days of receiving your denial. This appeal can be sent by phone, in writing by US Mail, by fax, or by email.
Immigrants with qualified immigration status (lawful permanent resident after five years) are eligible for IHCPs. Prior to attaining lawful permanent resident status, immigrants can utilize emergency services only (“Package E”) which also includes labor and delivery services for pregnant women. Immigrants may also purchase coverage through Marketplace.
If you were already enrolled in an IHCP prior to the current Public Health Emergency (PHE) – as of March 18, 2020 – your coverage cannot be discontinued! However, if you were due for renewal after March 18, when the PHE is lifted you will be required to produce all necessary documentation to renew your coverage the same as if the PHE had not occurred. Time limits are imposed, so be ready with your renewal information. If you need assistance, contact a licensed Indiana insurance navigator.
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Indiana Family & Social Services Administration. (2020). Eligibility Guide. Retrieved from https://www.in.gov/medicaid/members/59.htm
Indiana Family & Social Services Administration. (2020, September 30). Find My Local DFR Office. Retrieved from https://www.in.gov/fssa/dfr/ebt-hoosier-works-card/find-my-local-dfr-office/
Indiana Rural Health Association. (2020). Connecting Kids to Coverage Indiana. Retrieved from www.indianaruralhealth.org/CKC-IN
Kaiser Family Foundation. (2020, September 22). Uninsured rates for the nonelderly by age. Retrieved from State Health Facts: https://www.kff.org/uninsured/state-indicator/rate-by-age/?currentTimeframe=0&selectedRows=%7B%22wrapups%22:%7B%22united-states%22:%7B%7D%7D,%22states%22:%7B%22indiana%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Norris, L. (2020, July 9). Indiana and the ACA’s Medicaid Expansion. Retrieved from healthinsurance.org: https://www.healthinsurance.org/indiana-medicaid/