| Healthy Indiana Plan |
|
|
|
|
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.)
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.
|
