Healthy Indiana Plan

January 29th, 2008  |  Published in Bloomington, Healthy Indiana Plan  |  34 Comments

Currently, I don’t have any health insurance. I think this is true for most of my peers, and for many low-income people, whether they’re low-income because of lifestyle and career choices, like me, or because they lack the economic mobility to obtain incomes that would allow for jobs that provide health coverage or with incomes that would allow the purchase of individual insurance.

Currently, I have access to some medical care through the Monroe County Volunteers in Medicine clinic, which offers free medical and dental care, similar to what you would receive from a family doctor or dentist to residents of Monroe County who are below 200% of the federal poverty level (FPL). This is certainly a good resource, but I’m not sure how far the care extends for advanced procedures, or in the event of some kind of emergency or catastrophic illness or injury.

Indiana recently introduced the Healthy Indiana Plan which is state-subsidized health insurance for low-income Indiana residents. Again, to qualify for this, one must be a legal Indiana resident, between 19 and 64, and make less than 200% of the FPLwhich amounts to:

Family Size Maximum Annual Income* Approximate Maximum Monthly Income
1 $20,400 $1,700
2 $27,360 $2,280
3 $34,320 $2,860
4 $41,280 $3,440
5 $48,240 $4,020

The cost of this insurance will be between 2 and 5% of the gross family income for qualifying people, and according to the HIP website, the coverage includes:

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 also included and is similar to coverage for physical health, and includes substance abuse treatment, inpatient, outpatient, and prescription drugs.

The HIP coverage is 3-tiered and structured like this:

  • 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 (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 preventive services up to $500 a year at no cost to participants.

This seems very Republican (relative to some of the rhethoric I’ve heard in the news about different suggestions for health coverage policies) in it’s design because of the inclusion of the POWER Account (which I assume is what I’ve heard called a medical savings account) and because the plan seems to be administered by two private carriers: Anthem Blue Cross/Blue Shield and MDWise with AmeriChoice.

I believe that coverage will be limited to around 30,000 people (due to limitations on funding) and the plan will be funded by an increased tax on cigarette sales, but haven’t confirmed this in the actual release of the plan.

Of personal interest to me is the fact that it seems that much of the plan information is accessed and administered via the Internet. All plan participants must have an e-mail account (or will be given one if they do not) and both carriers list “Community Resource Centers” with internet access as part of their “Enhanced Services”. I think that more and more social services are using Internet technologies because they allow for cost savings. However, I fear that the costs of home Internet access (particularly for people with bad/no credit), unfamiliarity or discomfort with using Internet services, and the restrictions on access to public Internet resources like libraries or community resource centers (hours that the facilities are open may not match work schedules, no childcare options) may make the navigation of social services more alienating for their users.

In any case, I’m going to apply for the HIP and blog about my experiences.

Link to HIP home page
Link
to summary of HIP

  • http://HIPIndiana James Simmons

    I am interested in following the progress on this persons HIP application. I have helped a friend submit an application. It was mailed around January 10th and still nothing has been heard from the people running the program. A phone call to them this week resulted in them saying “you will receive info by mail”. At the time of application this person did not have e-mail, she has since gotten an e-mail account. Anything happened with your application yet? Any news to report?
    thanks

  • http://blogs.terrorware.com/geoff/ geoff

    I haven’t heard anything about my application either.

  • http://www.facebook.com/people/Geoffrey-Hing/1258700749 <fb:name linked="false" useyou="false" uid="1258700749">Geoffrey Hing</fb:name>

    I haven’t heard anything about my application either.

  • Jillian Jones

    I sent my application in on Dec 17th, I sent everything that I could think of that they may want! Supporting documentation of all income, child support, tax statements, bank statements, all utilities…… everything!!
    I did not hear from them for so long and tried to remain calm! As I have not had insurance since my divorce many years ago!
    Finally on Feb 16th I received the good news – insurance for me for little of nothing per month! When I bought private insurance for myself it cost me 8 fold of what they will charge me for this.
    I sent my first “POWER ACCOUNT” payment on Feb 16th, the check was cashed on Feb 26th…… I have not heard anything to this point about what is happening from here………… I am so excited and much relieved….. Thank you so much for this opportunity to be healthy in Indiana

  • Jillian Jones

    I sent my application in on Dec 17th, I sent everything that I could think of that they may want! Supporting documentation of all income, child support, tax statements, bank statements, all utilities…… everything!!
    I did not hear from them for so long and tried to remain calm! As I have not had insurance since my divorce many years ago!
    Finally on Feb 16th I received the good news – insurance for me for little of nothing per month! When I bought private insurance for myself it cost me 8 fold of what they will charge me for this.
    I sent my first “POWER ACCOUNT” payment on Feb 16th, the check was cashed on Feb 26th…… I have not heard anything to this point about what is happening from here………… I am so excited and much relieved….. Thank you so much for this opportunity to be healthy in Indiana

  • slappedbymitch

    I personally feel like this a slap in the face to a lot of lower middle class hard working adults and also the elderly. While this may have been a very noble idea there are many unfair aspects. I currently am a family of 5 and do qualify on the high side of the scale but I basically work for insurance coverage for my family. My husbands company doesn’t have coverage so I took a job based solely on insurance coverage. I pay over $80 dollars a week for coverage that pays far less than this plan. So I am paying 3 times more than people making the same amount as we do with less coverage. I could easily quit and get a job without insurance aside from the fact that I have a chronic illness that costs way to much to self pay for 6 months. Also it underserves the elderly Part d members. They pay more than this and face a huge gap at the end of year and have to pay thousands of dollars out of pocket. There has to be a better solution and I don’t believe this is it.

  • slappedbymitch

    I personally feel like this a slap in the face to a lot of lower middle class hard working adults and also the elderly. While this may have been a very noble idea there are many unfair aspects. I currently am a family of 5 and do qualify on the high side of the scale but I basically work for insurance coverage for my family. My husbands company doesn’t have coverage so I took a job based solely on insurance coverage. I pay over $80 dollars a week for coverage that pays far less than this plan. So I am paying 3 times more than people making the same amount as we do with less coverage. I could easily quit and get a job without insurance aside from the fact that I have a chronic illness that costs way to much to self pay for 6 months. Also it underserves the elderly Part d members. They pay more than this and face a huge gap at the end of year and have to pay thousands of dollars out of pocket. There has to be a better solution and I don’t believe this is it.

  • Katie

    Which is the better plan to apply for? Anthem HIP or MDWise HIP? I have found a lot of information about the Anthem HIP program but MDWise does not have any detailed information on their website about HIP.

  • Katie

    Which is the better plan to apply for? Anthem HIP or MDWise HIP? I have found a lot of information about the Anthem HIP program but MDWise does not have any detailed information on their website about HIP.

  • http://blogs.terrorware.com/geoff/ geoff

    Katie,

    I found info at http://www.in.gov/fssa/files/MAXI542_IN_HIP-PlanChartDEC20.pdf

    Personally, I chose MDWise because I had heard many bad things about Anthem in terms of people who were covered by it pre-HIP in Bloomington. Also, Anthem is currently involved in a lawsuit due to claims about how they offered virtually nonexistant coverage to many of their customers. I found an article about this at http://www.medicalnewstoday.com/articles/104511.php

  • http://www.facebook.com/people/Geoffrey-Hing/1258700749 <fb:name linked="false" useyou="false" uid="1258700749">Geoffrey Hing</fb:name>

    Katie,

    I found info at http://www.in.gov/fssa/files/MAXI542_IN_HIP-PlanChartDEC20.pdf

    Personally, I chose MDWise because I had heard many bad things about Anthem in terms of people who were covered by it pre-HIP in Bloomington. Also, Anthem is currently involved in a lawsuit due to claims about how they offered virtually nonexistant coverage to many of their customers. I found an article about this at http://www.medicalnewstoday.com/articles/104511.php

  • http://blogs.terrorware.com/geoff/ geoff

    Katie,

    An update. I went to a forum on problems related to the FSSA privatization of medicade and foodstamp benefits yesterday. One person from a large Indiana pediatric care provider said that they were discouraging parents from using MDWise because the pediatric care provider hadn’t gotten payed correctly by MDWise in a year. The rep said that from a provider standpoint, they have a much better relationship with Anthem. The person was talking about Medicade and not HIP, but I just thought I’d share this perspective. I don’t know what it means for HIP users and for healthcare consumers instead of providers. It seems that, once again, none of the options are great.

    Good luck,
    Geoff

  • http://www.facebook.com/people/Geoffrey-Hing/1258700749 <fb:name linked="false" useyou="false" uid="1258700749">Geoffrey Hing</fb:name>

    Katie,

    An update. I went to a forum on problems related to the FSSA privatization of medicade and foodstamp benefits yesterday. One person from a large Indiana pediatric care provider said that they were discouraging parents from using MDWise because the pediatric care provider hadn’t gotten payed correctly by MDWise in a year. The rep said that from a provider standpoint, they have a much better relationship with Anthem. The person was talking about Medicade and not HIP, but I just thought I’d share this perspective. I don’t know what it means for HIP users and for healthcare consumers instead of providers. It seems that, once again, none of the options are great.

    Good luck,
    Geoff

  • NeededInsurance

    I have been disabled with a chronic illness and unable to work full-time. I have desparately needed a medication for this illness, but the medication is extremely expensive. The company offering the medication cancelled their “patient assistance program”, which left me with no medication and even more disabled. If a person in my position tries to apply for disability, I would be told that “I am refusing to take my medication, so case denied.” with no regard to the fact that I can’t afford the medication.

    I am currently enrolled in Anthem’s Healthy Indiana Plan, and it has been a GodSend. I am now able to take my medication. I’m still not able to work full-time, but my suffering is less.

    But, the plan isn’t perfect. I need to see a gastroenterogist, but there isn’t one covered under this plan within a 60 mile radius from where I live. With gas as high as it is and a very low income, this isn’t good. But I have faith that with time, this will improve. This is only the first year for this program.

    I encourage people who need this, to apply. It took a long time, but finally they responded and I now have health insurance.

    Best Wishes,

    NeededInsurance

  • NeededInsurance

    I have been disabled with a chronic illness and unable to work full-time. I have desparately needed a medication for this illness, but the medication is extremely expensive. The company offering the medication cancelled their “patient assistance program”, which left me with no medication and even more disabled. If a person in my position tries to apply for disability, I would be told that “I am refusing to take my medication, so case denied.” with no regard to the fact that I can’t afford the medication.

    I am currently enrolled in Anthem’s Healthy Indiana Plan, and it has been a GodSend. I am now able to take my medication. I’m still not able to work full-time, but my suffering is less.

    But, the plan isn’t perfect. I need to see a gastroenterogist, but there isn’t one covered under this plan within a 60 mile radius from where I live. With gas as high as it is and a very low income, this isn’t good. But I have faith that with time, this will improve. This is only the first year for this program.

    I encourage people who need this, to apply. It took a long time, but finally they responded and I now have health insurance.

    Best Wishes,

    NeededInsurance

  • Giancarlo

    Thank you for posting this blog. Until I found it I was very frustrated by the information provided on the in.gov website regarding the mdcare and anthem differences. This helped a lot!

  • Giancarlo

    Thank you for posting this blog. Until I found it I was very frustrated by the information provided on the in.gov website regarding the mdcare and anthem differences. This helped a lot!

  • Ayada

    no dental care = no insurance

  • Ayada

    no dental care = no insurance

  • http://www.physiciandesigns.com Malena

    is there a way to become a content writer for the site?

  • http://www.physiciandesigns.com Malena

    is there a way to become a content writer for the site?

  • http://blogs.terrorware.com/geoff/ geoff

    This is my personal blog, so while it is possible for others to become content writers, it might make sense to start a new blog about the HIP specifically (which I’m assuming is what you’re interested in writing about). You can contact me at geoff [*at*] terrorware [*dot*] com if this interests you.

  • http://www.facebook.com/people/Geoffrey-Hing/1258700749 <fb:name linked="false" useyou="false" uid="1258700749">Geoffrey Hing</fb:name>

    This is my personal blog, so while it is possible for others to become content writers, it might make sense to start a new blog about the HIP specifically (which I’m assuming is what you’re interested in writing about). You can contact me at geoff [*at*] terrorware [*dot*] com if this interests you.

  • Patrick

    I applied for my wife and I 11/13/08. They began processing 12/09/09 and was told it could take 45 days to process and qualify..(or not). on the 42nd day they requested info which I provided in a timely manner. Again they said it could once again take up to 45 days. I waited the 2nd 45 days and called them. They said they had mailed me a letter requesting even more info. again I complied. after weeks now of being told it was in for approval..(in the order they are received), I received a phone call today from HIP..(I never knew anyone who received a phone call) informing me we didnt qualify due to the fact we didnt have children and all available slots were full. We are now on a waiting list and if they ever open new slots we will receive a letter on how to re-apply for benefits. I’ve written the Govornor, Lt. Gov.,all congressmen and representatives in my district only getting help from 2 of them. Good luck people..God Bless. Until something drastic happens..I guess we sit and watch ourselves or loved ones dies. This info came today..April 24th 2009

  • Patrick

    I applied for my wife and I 11/13/08. They began processing 12/09/09 and was told it could take 45 days to process and qualify..(or not). on the 42nd day they requested info which I provided in a timely manner. Again they said it could once again take up to 45 days. I waited the 2nd 45 days and called them. They said they had mailed me a letter requesting even more info. again I complied. after weeks now of being told it was in for approval..(in the order they are received), I received a phone call today from HIP..(I never knew anyone who received a phone call) informing me we didnt qualify due to the fact we didnt have children and all available slots were full. We are now on a waiting list and if they ever open new slots we will receive a letter on how to re-apply for benefits. I’ve written the Govornor, Lt. Gov.,all congressmen and representatives in my district only getting help from 2 of them. Good luck people..God Bless. Until something drastic happens..I guess we sit and watch ourselves or loved ones dies. This info came today..April 24th 2009

  • ML Bloomington

    The Healthy Indiana Plan STINKS! I have no insurance, and my daughter, who just turned 19 and is a fulltime student (and was CUT OFF the Hoosier Healthwise PAID plan at 19)has no insurance either. We are at the volunteer clinic (thank God!) and the Healthy Indiana Plan, after about 2 months of waiting–finally sent us a letter saying that “THE HEALTHY INDIANA PLAN HAS REACHED ITS ALLOWABLE ENROLLEMENT LIMIT FOR ADULTS WITHOUT DEPENDENT CHIDLRE> NEW MEMBERS ARE NOT BEING ACCEPTED AT THIS TIME. Legal basis 405 IAC 9-4-6(a)” So there you are! There’s NO coverage, not even for people who are barely making ends meet at $13,000 per year! I agree with Patrick totally, and I everyone I know that applied did NOT receive this plan, and we want to know who in the heck EVER gets on it! We are ALL for a single payer medical system in this country, but knowing Indiana, it will try NOT to be a part of it if it can! Once again it is “planned obsolesence” for the poor!

  • ML Bloomington

    The Healthy Indiana Plan STINKS! I have no insurance, and my daughter, who just turned 19 and is a fulltime student (and was CUT OFF the Hoosier Healthwise PAID plan at 19)has no insurance either. We are at the volunteer clinic (thank God!) and the Healthy Indiana Plan, after about 2 months of waiting–finally sent us a letter saying that “THE HEALTHY INDIANA PLAN HAS REACHED ITS ALLOWABLE ENROLLEMENT LIMIT FOR ADULTS WITHOUT DEPENDENT CHIDLRE> NEW MEMBERS ARE NOT BEING ACCEPTED AT THIS TIME. Legal basis 405 IAC 9-4-6(a)” So there you are! There’s NO coverage, not even for people who are barely making ends meet at $13,000 per year! I agree with Patrick totally, and I everyone I know that applied did NOT receive this plan, and we want to know who in the heck EVER gets on it! We are ALL for a single payer medical system in this country, but knowing Indiana, it will try NOT to be a part of it if it can! Once again it is “planned obsolesence” for the poor!

  • TS bloomington

    HIP plan REALLY stinks. Got on this plan by filling out a ton of paperwork made the required $48 payments each month was assigned an Doctor in Bedford I never could find and but thankfully I never need medical help. Because I took a 3 month contract job that has no medical insurance, out of state I am told I am NOT covered but have to pay the premiums each month anyway! And because I never filled out the renewal paperwork, I can’t reapply until 12 months have passed! WTF!

  • TS bloomington

    HIP plan REALLY stinks. Got on this plan by filling out a ton of paperwork made the required $48 payments each month was assigned an Doctor in Bedford I never could find and but thankfully I never need medical help. Because I took a 3 month contract job that has no medical insurance, out of state I am told I am NOT covered but have to pay the premiums each month anyway! And because I never filled out the renewal paperwork, I can’t reapply until 12 months have passed! WTF!

  • Ed Learned

    For all you unfortunate people struggling with the “Healthy Indiana Plan” (HIP plan), do NOT tolerate long delays after application and/or denial of coverage while you are outside of Indiana! Forcing people to pay for health insurance coverage which is thereafter denied is both illegal and immoral. Let’s investigate the facts! In a 54 page approval document dated Dec. 14, 2007 and sent to E. Mitchell Roob (then Secretary of the Indiana Family and Social Services Administration, or FSSA for short), the Administrator of the U.S. Dept. of Health and Human Services plainly stated many conditions under which the Indiana HIP plan was approved. Among those conditions you will find, “DFR will make a final eligibility determination within 45 days of the signed application date. This 45-day period is inclusive of the 35 days the DEC has to forward the completed application to DFR.” DFR means Division of Family Resources. You will also find, “residency requirement for receiving welfare benefits was unconstitutional because it interfered with a person’s fundamental RIGHT of INTERSTATE movement.” Since the supreme court recognizes that right, then you, as a citizen of the USA, have the right to move freely within the USA. There ARE provisions for “out of network coverage in the Healthy Indiana Plan! “For covered services provided out-of-network, if the out-of-network provider lacks the capacity to conduct the transaction using the enrollee’s card, the MCO or ESP will reimburse the out-of-network provider with funds from the enrollee’s POWER Account.” There it is in plain text! If Indiana FSSA or DFR or Anthem or any other insurance company similar to Anthem is violating ANY provision in the conditions under which the plan was approved, INSISTENTLY COMPLAIN to the Federal overseer (U.S. Dept. of Health and Human Services) at 1-877-696-6775 AND to your Indiana legislators. DEMAND intervention by your legislators because all of it was paid for with tax dollars! Do NOT try to resolve the issue with the “provider” (an insurance company such as Anthem) or you will get nowhere fast! Unfortunately, it is the same situation with Indiana’s FSSA.

  • Ed Learned

    For all you unfortunate people struggling with the “Healthy Indiana Plan” (HIP plan), do NOT tolerate long delays after application and/or denial of coverage while you are outside of Indiana! Forcing people to pay for health insurance coverage which is thereafter denied is both illegal and immoral. Let’s investigate the facts! In a 54 page approval document dated Dec. 14, 2007 and sent to E. Mitchell Roob (then Secretary of the Indiana Family and Social Services Administration, or FSSA for short), the Administrator of the U.S. Dept. of Health and Human Services plainly stated many conditions under which the Indiana HIP plan was approved. Among those conditions you will find, “DFR will make a final eligibility determination within 45 days of the signed application date. This 45-day period is inclusive of the 35 days the DEC has to forward the completed application to DFR.” DFR means Division of Family Resources. You will also find, “residency requirement for receiving welfare benefits was unconstitutional because it interfered with a person’s fundamental RIGHT of INTERSTATE movement.” Since the supreme court recognizes that right, then you, as a citizen of the USA, have the right to move freely within the USA. There ARE provisions for “out of network coverage in the Healthy Indiana Plan! “For covered services provided out-of-network, if the out-of-network provider lacks the capacity to conduct the transaction using the enrollee’s card, the MCO or ESP will reimburse the out-of-network provider with funds from the enrollee’s POWER Account.” There it is in plain text! If Indiana FSSA or DFR or Anthem or any other insurance company similar to Anthem is violating ANY provision in the conditions under which the plan was approved, INSISTENTLY COMPLAIN to the Federal overseer (U.S. Dept. of Health and Human Services) at 1-877-696-6775 AND to your Indiana legislators. DEMAND intervention by your legislators because all of it was paid for with tax dollars! Do NOT try to resolve the issue with the “provider” (an insurance company such as Anthem) or you will get nowhere fast! Unfortunately, it is the same situation with Indiana’s FSSA.

  • screwedBYhip

    I have had problems with this plan from the start. I applied the MOMENT they began taking applications on Dec 17th, 2007 at 12:01. After 60 days with no word, I called to check on the status of my app. Still processing. Long story short, it was July of 2008 when I received my approval and insurance card (which had the incorrect information on it). Oh, and the policy was back-dated so therefore I had to pay previous month’s premiums, even though I didn’t even know I was covered and didn’t seek medical attention for that reason. Two years later, I am still on the plan and still having problem with it. I have sent letters to 3 different legislators, none of which helped or even replied (but I sure was put on a monthly email list that clutters up my inbox). We cannot find doctors in our area who accept this insurance. Plus, most of the prescribed medications are not covered under the program. Enough of my ranting for now…I must call MdWise and sit on hold for a couple hours to discuss my plan!

  • screwedBYhip

    I have had problems with this plan from the start. I applied the MOMENT they began taking applications on Dec 17th, 2007 at 12:01. After 60 days with no word, I called to check on the status of my app. Still processing. Long story short, it was July of 2008 when I received my approval and insurance card (which had the incorrect information on it). Oh, and the policy was back-dated so therefore I had to pay previous month’s premiums, even though I didn’t even know I was covered and didn’t seek medical attention for that reason. Two years later, I am still on the plan and still having problem with it. I have sent letters to 3 different legislators, none of which helped or even replied (but I sure was put on a monthly email list that clutters up my inbox). We cannot find doctors in our area who accept this insurance. Plus, most of the prescribed medications are not covered under the program. Enough of my ranting for now…I must call MdWise and sit on hold for a couple hours to discuss my plan!

  • http://Google Saltonking44

    Can anyone say scam?

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