We have talked about The Federal Marketplace, Medicare, and Open Enrollment. The third type of health insurance we will look at is Medicaid. The good news about Medicaid is there is NO OPEN ENROLLMENT! You can apply for Medicaid programs any day of the year.
Medicaid is a social health care program for families and individuals with low incomes and certain disabilities.
The Affordable Care Act (ACA) expanded eligibility and federal dollars for Medicaid. However, each state was given the choice of how it would expand Medicaid. As a result, each state has different rules for Medicaid. It does not transfer from state to state.
Indiana has three main programs with different names and rules.
Hoosier Healthwise (HHW)
HHW is for children up to age 19 and pregnant women.
Package A (Standard Plan) includes the following:
- Full service
- No premiums
- May have small copay of $.50-$3 for pharmacy, transportation, or emergency services.
Package C (Children's Health Insurance Program or "CHIP") includes the following:
- Small monthly premium and copayment based on family income.
Package P (Presumptive Eligibility for Pregnant Women or "PEPW") includes the following:
- Limited service for prenatal care while full application is being processed.
Hoosier Care Connect (HCC)
HCC is a coordinated care program for people who have a disability and are not eligible for Medicare. They may be aged, blind, or disabled. Members receive all Medicaid-covered benefits plus care coordination services. Members on Medicaid for Employees with Disabilities (M.E.D. Works) are also on HCC.
Healthy Indiana Plan (HIP)
HIP covers adults 19-64 years of age whose incomes are less than 138% of the federal poverty level. There are two types of HIP:
- HIP Basic is a fee for service plan. This means that you pay an amount every time you use it. This includes doctor visits, medicines, hospitals, labs, and X-rays. This is usually $4.
- HIP Plus is a program where you make a contribution every month to a Power Account but don't have copays when you use it. The contribution is 2% of your income. This program also covers dental and vision.