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Managed Care Health Plans

The Indiana Health Coverage Programs (IHCP) works with five health plans to serve as managed care entities (MCEs) for the Hoosier Healthwise, Healthy Indiana Plan (HIP), and Hoosier Care Connect programs:

  • Hoosier Healthwise 
    Served by: Anthem, CareSource, Managed Health Services (MHS), and MDwise
  • Healthy Indiana Plan
    Served by: Anthem, CareSource, MHS, and MDwise
  • Hoosier Care Connect
    Served by: Anthem, MHS, and UnitedHealthcare

Each health plan is responsible for ensuring access and quality care for its assigned members. New Hoosier Healthwise, HIP, and Hoosier Care Connect participants have the option to select a health plan or be auto-assigned. More information about member assignments can be found on the enrollment broker business partner page.

Contact information for both members and providers can be found on the IHCP Quick Reference Guide.

The IHCP delegates the following services to the managed care health plan partners that serve Hoosier Healthwise, HIP, and Hoosier Care Connect participants:

  • Provider network development including contracting and credentialing
  • Care management and disease management
  • Member and provider contact centers
  • Provider outreach and education
  • Member outreach
  • Claim processing (medical, behavioral health, dental, vision, and pharmacy)
  • Claim disputes and appeals
  • Utilization management (prior authorization)
  • Utilization management disputes and appeals
  • Program integrity
  • Pharmacy preferred drug list development
  • Quality incentive programs
  • Nonemergency medical transportation

Information on State oversight of managed care health plans and quality-improvement activities can be found at the Indiana Office of Medicaid Policy and Planning (OMPP) Quality and Outcomes Reporting web page. Managed care health plan contracts, external quality reviews, quality strategy plans, and summaries of operational reports can all be found in this location.

The Managed Care Health Plan restricted site is a password-protected area that contains MCE policy-and-procedure manuals for each managed care program as well as other resources for IHCP-contracted health plans.

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