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State Health Reform Laws
Indiana
Full
text of legislation
The following is a summary of the The Healthy Indiana
Plan (HIP), enacted May 2007. For more information, visit www.HIP.IN.gov
or call (877) GET-HIP-9.
Who Is Covered?
HIP is for uninsured Hoosier adults between the ages of 19-64. Parents
or caretaker relatives of children in the Hoosier Healthwise program
are likely candidates for HIP.
Eligibility Requirements:
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Individuals must earn less than 200% of the federal
poverty level (FPL). A single adult earning less than $20,000, or
families of four earning less than $40,000 likely meet the basic
financial requirements.
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Individuals must not have access to employer sponsored
health insurance coverage.
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Individuals must be uinsured for the previous six
months.
Plan Structure
The Plan provides:
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A POWER Account valued at $1,100 per adult to pay
for medical costs. Contributions to the account are made by the
State and each participant (based on ability to pay). No participant
will pay more than 5% of his/her gross family income on the plan.
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A basic commercial benefits package once annual
medical costs exceed $1,100.
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Coverage for preventive services up to $500 a year
at no cost to participants.
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Services include: physician services, prescriptions,
diagnostic exams, home health services, outpatient hospital, inpatient
hospital, hospice, preventive services, family planning, and case
and disease management
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Mental health coverage is similar to coverage for
physical health, and includes substance abuse treatment, inpatient,
outpatient, and drugs
* Caretaker relatives/ parental adults in this income bracket
contribute 4.5%, and the childless adults contribute 5%.
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No co-pays except for ER use.
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If all age and gender appropriate preventive services
are completed, all (State and individual) remaining POWER Account
funds will rollover to offset the following year’s contribution.
If preventive services are not completed, only the individual’s
prorated contribution (not the State’s) to the account rolls
over.
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