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What are POWER Accounts?
A POWER Account is a special savings account that members use to pay for health care. Every HIP member has a POWER Account. The POWER Account is used to pay for the first $2,500 in health care costs.
The state of Indiana pays for most of the $2,500 in the POWER account, but the member is responsible for a fixed monthly payment depending on income. The member contribution amounts are between $1 and $20, but may be higher for members that smoke. When a member makes a POWER account payment, they become enrolled in HIP Plus, which offers better health coverage, including vision, dental and chiropractic benefits.
If annual health care expenses are more than $2,500, the first $2,500 is covered by the member's POWER account, and expenses for additional health services over $2,500 are fully covered at no additional cost to the member (except in the HIP Basic program where the member is responsible for any required copayments).
Some members can have HIP Basic coverage even if they don’t make their monthly payment, but in HIP Basic they will have to pay a fee every time they go to the doctor or fill a prescription. In HIP Plus, monthly POWER account payments are members’ only health care costs outside of any non-emergency visits to the emergency room.
Members who leave HIP and return in the same calendar year will still have their same POWER account and health plan.
The contributions you make to your new POWER account will be yours. If you choose to leave the program early, your contributions not spent on health care costs may be returned to you.
Managing your account well and getting preventive care can reduce your future costs. In HIP, if your annual health care expenses are less than $2,500 per year you may rollover your remaining contributions to reduce your monthly payment for the next year. You can also double your reduction if you complete preventive services.
What are the contribution amounts?
Monthly POWER account contributions are determined by family income compared to the federal poverty level as shown below. Members who indicate that they are tobacco users during the plan selection period in the fall, may be subject to an increased contribution amount in the following year if they are still smoking.
|FPL||Monthly PAC Single Individual||Monthly PAC Spouses||PAC with tobacco surcharge||Spouse PAC when one has tobacco surcharge||Spouse PAC when both have tobacco surcharge (each)|
|<22%||$1.00||$1.00||$1.50||$1.00 and $1.50||$1.50|
|23-50%||$5.00||$2.50||$7.50||$2.50 and $3.75||$3.75|
|51-75%||$10.00||$5.00||$15.00||$5.00 and $7.50||$7.50|
|76-100%||$15.00||$7.50||$22.50||$7.50 and $11.25||$11.25|
|101-138%||$20.00||$10.00||$30.00||$10.00 and $15.00||$15.00|
Federal poverty levels are based on income and family size and contribution amounts for all family sizes can be calculated using this tool.
As long as members make their required monthly POWER account contributions, they will have no other costs. The only exception to this is a charge of $8 if a member goes to the hospital emergency room for a non-emergency. Each month, the member’s health plan will send a monthly statement showing how much is left in their POWER account.
Why is it important to make POWER account contributions?
POWER account contributions are a key part of the Healthy Indiana Plan. Members who make POWER account contributions on-time each month participate in HIP Plus where they have better benefits and predictable costs. Members with incomes above the poverty level, for example $12,140 a year for an individual, $16,460 for a couple or $25,100 for a family of four in 2018, that choose not to make their POWER account contributions will be removed from the program and not be allowed to re-enroll for six months. This enrollment lockout will not apply if the member is medically frail or residing in a domestic violence shelter or in a state-declared disaster area.
Members who have incomes below the federal poverty level who do not make their contributions will be moved to the HIP Basic plan. HIP Basic does not cover vision, dental or chiropractic services and could be more expensive. HIP Basic requires members to make a small payment, called a copayment, each time they go to the doctor or hospital except for preventive care or family planning services. The HIP Basic plan will charge copayments for health care services.
Unlike POWER account contributions, which belong to the member and could be returned if the member leaves the program early, copays cannot be returned to the member.
HIP Basic members will be given the opportunity to reenroll in HIP Plus at the end of their annual cycle, or plan year, defined by their enrollment date. HIP Basic members also receive an opportunity to move to HIP Plus if they earned rollover in the prior calendar year.
Where and how can you pay your POWER account contribution?
POWER account contributions are paid directly to the member's health plan (Anthem, MDwise, CareSource or MHS). Members will receive information from their health plans about the various ways POWER account contributions can be paid. These include by mail, over the phone, online and via payroll deduction through the member's employer. Each health plan also has designated retail locations around the state where you can make your payment in person. Call your health plan for details about these options and locations.
How do I monitor my POWER account?
Members receive monthly statements that show how much money is remaining in the POWER account. Members who manage their health and POWER accounts wisely could still have money in their accounts after a year of coverage. These remaining funds can be used to lower POWER account contributions for the next year of coverage. Every calendar year, members get a new $2,500 POWER account amount to pay for HIP covered medical expenses.