Applications for the Healthy Indiana Plan established by House Enrolled Act 1687 are now available on the FSSA web site at www.in.gov/fssa/hip.  Applications will be accepted starting December 17.

Who Is Covered?

The plan is for people age 18 through 64 who:

o       Are at 200% of Federal Poverty Level (FPL) or below,

o       Have not had insurance for 6 months,

o       Do not have a group insurance policy available to them,

o       Do not qualify for Medicaid or disability,

o       Are not pregnant. (Pregnant women up to 200% FPL will automatically qualify for Medicaid.)

About the Plan

The Plan provides:

o       A POWER Account valued at $1,100 per adult to pay for medical costs,

o       State contributions to the POWER account accompanied by contributions from the participants (based on ability to pay),

o       No participant's contribution will be more than 5% of his/her gross family income,

o       Insurance coverage once annual medical costs exceed $1,100,

o       Coverage for preventive services up to $500 a year at no cost to participants.

What is covered?

o       Covered services include: physician services, prescription drugs, diagnostic exams, home health services, outpatient hospital, inpatient hospital, hospice, preventive services, family planning, and case and disease management.

o       Mental health coverage is similar to coverage for physical health, and includes substance abuse treatment, inpatient, outpatient, and drugs.

o       Vision and/or dental coverage can be purchased as a rider. Individuals will pay 50% of the premium cost (on top of their POWER Account contribution) for these services.
 

Other Plan Specifics:

 o      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: 5%

o       No co-pays except for ER use if all age, sex, and pre-existing condition appropriate preventive services are completed.

o       All (State and Individual) remaining POWER Account funds will rollover to offset the following year's contribution.

o       If preventive services are not completed, only the individual's prorated contribution (not the State's) to the account rolls over to the following year.