State Submits HIP And HIP 2.0 Waiver

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July 1, 2014 —

INDIANAPOLIS- Gov. Mike Pence’s office said two waivers for Indiana’s health plan would be submitted to the federal government before the midnight deadline.

One waiver will look to continue the state’s current Healthy Indiana Plan, which covers an estimated 45,000 Hoosiers, according the Indiana Family and Social Services Administration.

However, that plan will serve as a backup just in case Healthy Indiana Plan 2.0 is not accepted by the federal government.

Jim Gavin – spokesman for Families and Social Services Administration – said there was no timetable for when they might hear back from the federal government.

HIP 2.0, if accepted, will expand on the current plan and cover an estimated 1 million Hoosiers.

The plan will serve as an alternative to Medicaid and Pence’s office said the plan will promote responsibility and consumer-directed principles.

The plan will apply to all non-disabled adults ages 19-64, who earn between 23 percent and 138 percent of the federal poverty level. That means it covers individuals with a maximum income of $16,105 and $32,913 for a family of four.

HIP 2.0 will provide three options to choose from based on responsibility and consumer behavior. Each plan includes a Personal Wellness and Responsibility (POWER) account that helps pay for deductibles.

The first plan, Employer Benefit Link, will provide financial support to members who wish to access employer-sponsored insurance options. It allows for greater choices and increases access to providers while encouraging the use of existing private insurance options.

Individuals who are deemed eligible can pick an employer-sponsored plan they think works best for them. The enrollment in this plan is optional.

The second plan, Plus, would serve as a consumer-driven Medicaid alternative for Hoosiers with incomes below 138 percent of the federal poverty level. It is available to members who make their monthly POWER account contributions, ranging from $3 to $25.

Members and the state will jointly fund a $2,500 POWER account, which members contribute to based on their income salary.

Plus will offer enhanced benefits such as vision and dental services and includes comprehensive prescription drug benefits. It also covers maternity services with no cost-sharing during the duration of the pregnancy.

The third plan, Basic, will serve as a default for Hoosiers that fall well below 100 percent of the federal poverty level and fail to make their POWER account contributions. However, it will require a co-payment for all services.

Members of the Basic plan will use the state-funded POWER account to cover their $2,500 annual deductible.

The plan will have a reduced benefits package along with limited prescription drug benefits.

Also, it will provide incentives for members to be more cost-conscious and to recommend preventive care.

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