HIP (Healthy Indiana Plan)

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 Healthy Indiana Plan (HIP) covers Indiana residents who meet the following criteria:

  • Age 19-64
  • Income under approximately 138% of the federal poverty level (FPL)
  • Not eligible for Medicare or other Medicaid categories

The Healthy Indiana Plan (HIP) has two plans. There are two distinct levels of coverage in HIP 2.0: HIP Plus and HIP Basic. Each covers medical expenses such as doctor visits, hospital care, therapies, medications, prescriptions and medical equipment. HIP Plus offers members the best value and, unlike HIP Basic, also covers vision and dental care, and even bariatric surgery.

HIP Plus
The initial plan selection for all members is HIP Plus which offers the best value for members. HIP Plus has comprehensive benefits including vision and dental. The member pays an affordable monthly POWER account contribution based on income. There is no copayment required for receiving services with one exception: using the emergency room where there is no true emergency.

HIP Basic
HIP Basic is the fallback option for members with household income less than or equal to 100 percent of the federal poverty level (FPL) who don't make their POWER account contributions. The benefits are reduced. The essential health benefits are covered but not vision or dental services. The member is also required to make a copayment each time he or she receives a health care service, such as going to the doctor, filling a prescription or staying in the hospital. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. HIP Basic can be much more expensive than HIP Plus.

How does HIP coverage work?

In the HIP program, in each calendar year the first $2,500 of a member’s medical expenses for covered benefits are paid with a special savings account called a Personal Wellness and Responsibility (POWER) account. The state will pay most of this amount, but the member is also responsible for paying a small portion of their initial health care costs. The member’s portion is an affordable, monthly contribution based on income. The contribution that will be one of five affordable amounts between $1 and $20.

Managing your account well and getting preventive care can reduce your future costs. If your annual health care expenses are less than $2,500 per year, you may rollover your remaining contributions to reduce your monthly payment for the next year. You can also have the amount of your reduction doubled if you complete preventive services. If your annual health care expenses are more than $2,500, the first $2,500 is covered by your POWER account, and expenses for additional health services are fully covered at no additional cost to you.

In HIP, your contributions to your POWER account will be yours. If you choose to leave the program early, your contributions not spent on health care costs will be returned to you. A penalty is deducted if an individual is disenrolled due to non-payment or withdrawing from the program without having other coverage.

Managed Care

When enrolling in HIP, you will choose a managed care company.  Click here for a summary of benefits and contact information for the plans.

Get HIP benefits

Coverage for HIP Plus members begins in the month when their first POWER account contributions or Fast Track payments are received and processed. HIP Basic coverage begins the first of the month after the invoice payment period.

All HIP members will receive a letter informing them when coverage starts and how to get the most out of their HIP benefits.

How to Apply

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.

You can also apply online.  

Have more questions? Contact us!

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