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The Healthy Indiana Plan (HIP) has three pathways to coverage HIP Plus, HIP Basic and HIP Employer Link.
The initial plan selection for all members is HIP Plus which offers the best value for members. HIP Plus has comprehensive benefits including vision and dental. The member pays an affordable monthly POWER account contribution based on income. There is no copayment required for receiving services with one exception: using the emergency room where there is no true emergency.
HIP Basic is the fallback option for members with household income less than or equal to 100 percent of the federal poverty level (FPL) who don't make their POWER account contributions. The benefits are reduced. The essential health benefits are covered but not vision or dental services. The member is also required to make a copayment each time he or she receives a health care service, such as going to the doctor, filling a prescription or staying in the hospital. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. HIP Basic can be much more expensive than HIP Plus.
HIP Employer Link is an option for eligible members who work and have access to their employer's health plan. HIP Employer Link members will also have a POWER account and contribute to their coverage like other HIP members. But with HIP Employer Link, the POWER account can be used to pay the insurance premiums and out-of-pocket medical expenses associated with the member's employer-sponsored plan.
The employer must choose to participate in HIP Employer Link and be registered with the state. Employers also must contribute 50 percent of the member's premium. Members can receive guidance on the best coverage option.