Click to expandHow can I confirm that I will be reimbursed for a member's presumptive eligibility (PE) service?
The Indiana Health Coverage Programs (IHCP) PE acceptance letter clearly indicates the date a member's coverage begins and ends and the plan to which the member belongs, if applicable. This letter serves as the member's identification card. In addition, a member's eligibility is available in real time and should be viewable in the IHCP Provider Healthcare Portal at the time the acceptance letter is printed and sent.
Click to expandWhere can a PE member receive services?
The member is not limited to receiving services only from the provider location where he or she was determined presumptively eligible. Presumptively eligible members can receive services covered under their benefit plan from any IHCP-enrolled provider.
Click to expandWhat if a member's eligibility for services is denied via a pharmacy's point-of-sale system?
It may take up to 24 hours for a member's eligibility status to be visible in all eligibility systems, such as in the eligibility system of the pharmacy benefit manager. During that time, the member is eligible to receive services. The PE acceptance letter clearly indicates the date a member's coverage begins and ends, and serves as a member's identification card.