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Family and Social Services Administration

Healthy Indiana Plan

HIP > Guidance for Hoosiers enrolled in federally subsidized Health Insurance Marketplace plans Guidance for Hoosiers enrolled in federally subsidized Health Insurance Marketplace plans

Health Insurance Marketplace Open Enrollment 2016

The federal Health Insurance Marketplace is holding its annual open enrollment period for 2016 coverage beginning November 1, 2015, and ending on January 31, 2016. As part of this open enrollment period, the federal Health Insurance Marketplace will send letters to enrollees requesting updated information. If you have information to update, and return your letter to the Marketplace they will use your updated information to reassess your eligibility.

If you are currently enrolled in the Health Insurance Marketplace, and your income is below $1,383 per month for an individual or $2,828 for a family of four in 2016, you may be eligible for the Healthy Indiana Plan (HIP). If you return your updated information to the Health Insurance Marketplace and your income is below this amount, your information will be sent to the state to be assessed for eligibility for HIP or other state of Indiana coverage programs. You may also apply separately for HIP. If you receive notice that you are eligible for HIP coverage, you should make sure to cancel your health plan purchased on the Health Insurance Marketplace to avoid paying for two different coverage types. If your income is below these amounts and you want to stay on your coverage through the Health Insurance Marketplace, you do not need to take any action.

If you are currently enrolled in HIP and think you may be eligible for the coverage on the Health Insurance Marketplace you should report a change to the Division of Family Resources by calling or faxing information to the FSSA Document Center at 800-403-0864, mail to FSSA Document Center, PO Box 1810, Marion, IN 46952 or submit a change request through the FSSA Benefits portal at in.gov/fssa/dfr. If your income makes it so that you are no longer eligible for HIP, your information will be forwarded to the Marketplace.

For immediate transfer to HIP from the Health Insurance Marketplace

If you are currently enrolled in the Marketplace and receive Advanced Payments of the Premium Tax Credit (APTC) and your income is below $1,383 per month for an individual or $2,828 for a family of four in 2016, you may be eligible for the Healthy Indiana Plan (HIP). You can find out if you are eligible by going to www.Healthcare.gov and selecting “Report a Life Change” on your existing Marketplace application. Then click through the application. You should report any changes such as income, household or other relevant life changes. Even if your information has not changed, submit and verify this with the Marketplace. This will trigger the Marketplace to reexamine your eligibility. If the Marketplace thinks you may be eligible for HIP it will forward your information to Indiana Medicaid. In addition, individuals may learn that they are eligible for Medicaid or HIP by applying for coverage directly at Indiana Medicaid.

The following applies to any Indiana resident who is enrolled in a Marketplace plan and receiving the benefit of APTC, and who chooses to apply for HIP coverage:

  • If you are determined eligible for HIP by Indiana FSSA:
    • You will get information about your eligibility and then may choose a health plan (Anthem, MDWise or MHS) to manage your health care services. If one of these companies is providing your current Marketplace plan, it may also contact you directly about your possible eligibility for HIP.
    • You will receive a bill from your health plan for your monthly POWER account contribution. Paying this bill as soon as possible will guarantee you access to comprehensive coverage, without a gap in coverage.
    • You should visit the Marketplace to end your coverage with APTC as soon as you receive a final determination of HIP eligibility from Indiana FSSA. Otherwise, you will receive bills for two different coverages and may be liable to repay APTC received starting the first of the month following your HIP eligibility determination. Click here for instructions from www.HealthCare.gov on ending a Marketplace plan when you get Medicaid (including HIP).
  • If you are not determined eligible for HIP by Indiana FSSA:
    • You will receive a denial notice and you will keep the health insurance coverage you purchased on the Marketplace.
    • You will keep your APTC because you are not eligible for HIP.

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