Hoosier Healthwise 

 We offer FREE, LOCAL and unbiased help to get individuals and families connected to healthcare coverage programs.  Click here for the map to find local help. 

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

Hoosier Healthwise covers many different types of people:
  • Children up to age 19
  • Pregnant women
  • Parents/Guardians of children under the age of 18.
  • The Children's Health Insurance Plan (CHIP) for children up to age 19, falls under the Hoosier Healthwise program. In CHIP your child may be covered by paying a low-cost monthly premium. This option is available to members who may earn too much money to qualify for the standard Hoosier Healthwise coverage.
There are several benefit packages in Hoosier Healthwise. When you submit an application, the state will determine your eligibility and select the Package that is right for you.  Most children will fall into the Hoosier Healthwise Program Package A or C.  You may qualify for one of these two benefit packages based on income.

Package A - Standard Plan is a full-service plan for children, pregnant women, and families. Members have no premiums to pay but may have a $.50 to $3.00 co-pay for pharmacy, transportation and emergency services.

Eligibility Criteria:
  • Income up to 150% FPL (Federal Poverty Level)
  • Does not count resources
  • Can have private insurance
  • Comprehensive plan
  • No co-payments for children or pregnant women
  • Over the Counter (OTC) drugs covered
  • Coverage goes back 90 days prior to  date of application
Package C - Children's Health Insurance Program (CHIP) is a full-service plan for children only. There is a small monthly premium payment and co-pay for some services based on family income.

Eligibility Criteria
  • Income up to 250% FPL (Federal Poverty Level)
  • Does not count resources
  • Limited benefit plan
  • Premiums and co-pays based on income
  • Cannot have private insurance
  • Caps on Durable Medical Equipment of $2000/yr or $5000/lifetime
  • Over the Counter (OTC) drugs not covered
  • Coverage goes back to the 1st of the month the application was made
You cannot have private health insurance to qualify for Package C.

Family Planning Eligibility Program:  The Indiana Family Social Services Administration (FSSA) offers a Medicaid program, Family Planning Eligibility Program, allowing men and women the ability to receive certain family planning services. The Family Planning Eligibility Program provides services and supplies to men and women for the primary purpose of preventing or delaying pregnancy.
Eligibility Requirements:
  • Do not qualify for any other category of Medicaid
  • Be a U.S. citizen, certain lawful permanent resident, or certain qualified documented alien
  • Cannot be pregnant
  • Have not had a hysterectomy or sterilization
  • Have income that is at or below 141% of the federal poverty level

To apply

To apply for any of the above programs, you will need to fill out and submit an application.  Here are different options for applying: Once you submit your complete application, it will take about 45-90 days to determine if you are eligible. If you are a pregnant woman, you may be able to receive medical care while you wait for your application to be processed. 

NOTE:  When you enroll in Hoosier Healthwise you will need to select a Managed Healthcare Entity (or provider) or one will be selected for you.  
 

To Pay a Premium

If you are on a program that requires a monthly premium, here are the options to make the payments:
CHIP members who have questions about premium payments can call 1-866-404-7113.

To pay by phone:
1-855-765-8672

By Mail: 
Premium payment checks or money orders should be mailed to:
Hoosier Healthwise
P.O. Box 3127
Indianapolis
IN 46206-3127

Online

Hoosier Healthwise Package C & M.E.D. Works Premium Portal

Managed Care Entities

When you enroll in Hoosier Healthwise you will select a health plan. A health plan is a group of health care providers (primary care doctors, specialists, home health care providers, pharmacies, therapists etc.).

When you choose your doctor, you will also need to choose your health plan. It is important for you to know which health plan you and your doctor are in. For most health care services, you must use the health care providers who are in your health plan. Your health plan choices are:
  • Anthem
  • MDwise
  • Managed Health Services (MHS)
  • CareSource

WHAT IS COVERED BY HOOSIER HEALTHWISE?

You can view a general description of the benefits and services available in the Hoosier Healthwise program. Please remember that your health plan may offer additional services. The benefits covered by Hoosier Healthwise include preventive care (like well-baby/well-child care and regular check-ups) and mental health and substance abuse treatment. Hoosier Healthwise also has benefits for children with special health care needs like asthma or diabetes.

Once you are enrolled with a health plan, they will be your first stop for any questions about your care. If you are unsure of your benefits or have any questions about your coverage, call your health plan.

Anthem
www.anthem.com
Member Services
1-866-408-6131

MDwise
www.mdwise.org
Member Services
(317) 630-2831 or
1-800-356-1204

Managed Health Services (MHS)
www.mhsindiana.com 
Member Service
1-877-647-4848
 
CareSource
www.caresource.com
Member Services
1-800-418-0172
 

Have more questions? Contact us!

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