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Family and Social Services Administration

Healthy Indiana Plan

HIP > Redetermination Process Redetermination Process

HIP 2.0 redetermination process

HIP 2.0 began covering Hoosiers on February 1, 2015. By law, all HIP members must have their eligibility renewed every 12 months. Beginning in November, individuals who were enrolled as of February 1, 2015, will begin their annual renewal period to determine if they remain eligible for another year of coverage beginning February 1, 2016. This is also one of the periods when a HIP Basic member can move to HIP Plus, and we need your help promoting the benefits of HIP Plus.

This process will involve a series of notices sent to the members by mail. The process outlined below will be the same starting in December for members with a March 1 renewal date, in January for April 1 renewals, and so on.

Initial notice:

HIP members who began coverage February 1, 2015, will receive a letter in November that describes the redetermination process. This letter will also inform members that they may select a new plan option (managed care entity) for their coverage in 2016. (Going forward, all HIP members can expect to receive this redetermination letter within 90 days of the end of their current benefits. For example, members that began their coverage in March will receive this letter in December). HIP members need to carefully read this letter, and all subsequent correspondence, and follow all instructions.

An example of this letter is found by clicking here.

Changing plans:

Individuals who want to select a different benefit plan for their next coverage year must do so 45 days prior to the end of their current benefit year. The initial notice contains instructions on how to change plans during this timeframe. Plan changes will be effective February 1, 2016, if the individual is confirmed as eligible for another year of HIP coverage.

Follow up notice:

After the initial notice, HIP members may fall into one of three categories.

  1. Members who do not need to take action. These are members who have recently confirmed their information with the state and who, therefore, can be automatically found eligible for another year of coverage. These members will not receive a communication asking for more information, as no information is needed. In late December these members will receive notice of their new benefit period. This notice will also provide these members the amount of their HIP Plus POWER account contribution. This begins the opportunity for HIP Basic members to transition to HIP Plus. Members beginning a new benefit year in February can expect to receive an invoice from their health plan in January. Paying this invoice will guarantee provision of HIP Plus benefits. Starting a new benefit period is one of the opportunities for HIP Basic members to move to HIP Plus benefits.
  2. Members who need to take action if there are changes. HIP members who have not had their information confirmed with the state recently, but for whom information is available through electronic sources (information the state can use to determine eligibility) will receive a letter indicating what information the state will use to determine their eligibility for the next benefit year. If the information is incorrect, the member will be instructed to return their form and provide the correct information so their eligibility can be determined. In late December these members will receive notice of their new benefit period. This notice will also provide these members the amount of their HIP Plus POWER account contribution. This begins the opportunity for HIP Basic members to transition to HIP Plus. Members beginning a new benefit year in February can expect to receive an invoice from their health plan in January. Paying this invoice will guarantee HIP Plus benefits. Starting a new benefit period is one of the opportunities for HIP Basic members to move to HIP Plus benefits.
  3. Members who MUST take action. HIP members who have not recently confirmed their information with the state and who cannot have their eligibility confirmed through electronic sources will receive a form that will indicate it must be returned. This form must be returned by the due date on the form, and these members must verify their information even if the information preprinted on the form has not changed. Individuals who do not return this form will not be eligible for continued coverage and will not be eligible to reapply for six months after the end of their benefit period. The form will make clear that action is required to continue HIP eligibility. In late December, members in this group who successfully complete their redetermination and are found eligible for HIP for another year will receive notice of their new benefit period. This notice will also provide these members the amount of their HIP Plus POWER account contribution. This begins the opportunity for HIP Basic members to transition to HIP Plus. Members beginning a new benefit year in February can expect to receive an invoice from their health plan in January. Paying this invoice will guarantee provision of HIP Plus benefits. Starting a new benefit period is one of the opportunities for HIP Basic members to move to HIP Plus benefits.

Examples of these notices are contained within this document.

HIP Plus enrollment for basic members

During the first 60 days of their new benefit period all members that are currently in HIP Basic or HIP State Plan Basic will have the opportunity to begin making POWER account contributions to enroll in HIP Plus. HIP Plus members receive enhanced benefits such as vision and dental coverage and do not face copayments unless using the ER for a non-emergency. HIP Basic members would continue to receive HIP Basic benefits and have copayments applied for services until they make their POWER account contribution for HIP Plus.

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