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Hoosier Healthwise

Overview

Hoosier Healthwise is a health care program for children up to age 19 and pregnant women. The program covers medical care like doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost to the member or the member's family.

The Children's Health Insurance Program (CHIP) falls under the Hoosier Healthwise program. CHIP is for children up to age 19 whose families have slightly higher incomes. In CHIP, members are required to pay a low monthly premium for coverage as well as copays for certain services.

Covered Services

There are two benefit packages within Hoosier Healthwise:

  • Package A - This is a full-service plan for children and pregnant women. Members do not have any cost sharing obligations.

  • Package C - This is a full-service plan for children enrolled in CHIP. There is a small monthly premium payment and co-pay for some services based on family income.

For a general description of the benefits and services under these benefit packages, refer to the Indiana Medicaid Covered Services page. Individual health plans may offer additional services.

Member Information

  • For eligibility information, including income requirements, for Hoosier Healthwise-Package A, refer to the Eligibility Guide.

  • For eligibility information, including income requirements, as well as premium and copay information for Package C, refer to the Premium Payments page.

  • If you are a pregnant woman, you may be able to receive medical care while you wait for your application to be processed. Please refer to Presumptive Eligibility for more info.

  • You can find information about the program within the Hoosier Healthwise Brochure.

  • When you enroll with Hoosier Healthwise, you must select a health plan. You may choose among the following:

    • Anthem

    • CareSource

    • Managed Health Services (MHS)

    • MDwise

  • You can visit the Working With Your Health Plan page to select the best health plan for you. You can also find a Summary of the Hoosier Healthwise Health Plans.

  • Once you have selected a health plan, you will be asked a series of questions about your health care. These questions will allow the health plan to understand your needs so that they may provide you with all the services you need. If you have extra needs, the health plan will ask you some more specific questions so that they may be further involved with your health care treatment.

  • If you have questions about your benefits or your coverage, you should contact your health plan or the Indiana Medicaid enrollment broker, Maximus. You can find the phone numbers on the Contact Us webpage.

Provider Information

  • The Hoosier Healthwise program is operated within the managed care delivery system. Contracted managed care entities (MCEs) arrange, administer, and pay for the delivery of healthcare services to members enrolled in their health plan. All services, except Medicaid Rehabilitation Option (MRO) services, is provided through the MCEs, including dental and pharmacy services.

  • Four MCEs are contracted with the state of Indiana to serve the Hoosier Healthwise population. Links to their provider websites are provided below:

  • The care of Hoosier Healthwise members is managed through a network of primary medical providers (PMPs), specialists, and other providers that contract directly with the MCE. To be reimbursed for services provided to Hoosier Healthwise members, providers must be enrolled with the IHCP (refer to the Become a Provider web page). After successfully enrolling in the IHCP, a provider can contract with one or more of the MCEs to serve their enrolling members.

  • For more information or questions about the Hoosier Healthwise health plans, contact the MCEs directly. See the IHCP Quick Reference Guide for contact information.

  • Additional provider resources regarding Hoosier Healthwise are available at the following links:

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