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3500.00.00 ELIGIBILITY STANDARDS

This chapter includes the following sections.

• Overview of the Healthy Indiana Plan (Section 3505) • Request for an Application for the Healthy Indiana Plan (Section 3510) • General Eligibility Requirements: Age and Health Insurance (Section 3515) • Categorical Eligibility for HIP (Section 3520) • Financial Eligibility Requirements (Section 3530) • POWER Account Contribution Eligibility Requirements (Section 3540) • Loss of Eligibility (Section 3550) • Re-calculation Due to Qualifying Event (Section 3560) • HIP I.D. Cards (Section 3570).

3505.00.00 OVERVIEW OF THE HEALTHY INDIANA PLAN (HIP)

The Healthy Indiana Plan (HIP) is a demonstration waiver approved under Section 1115(a) of the Social Security Act effective January 1, 2008, and it was authorized to continue through January 31, 2014.

HIP 2.0 is a demonstration waiver approved under Section 1115(a) of the Social Security Act effective February 1, 2015, and is authorized to run for 3 years and is subject to renewal.

Effective February 1, 2018, the HIP waiver was extended for another three years with improvements and updates that will be explained in the following sections. The authority for this program is derived from the Special Terms and Conditions approved by the Centers for Medicare and Medicaid Services (CMS), along with regulations at 405 Indiana Administrative Code Article 9. HIP provides a comprehensive benefit plan for eligible uninsured adults. It is a high-deductible health plan that utilizes an account like a health savings account called the POWER account - Personal Wellness and Responsibility Account - which provides incentives for members to obtain recommended preventive care.

The following sections of this chapter explain the eligibility requirements and methodologies used by the Division of Family Resources to determine HIP eligibility and the policies regarding POWER account contributions. Additional information about HIP and how to apply can be found on the website www.in.gov/fssa/HIP/.

3510.00.00 MCE SELECTION PERIOD FOR HIP MEMBERS (MCE LOCK-IN)

Once fully open after an application, all HIP members are assigned and/or select an MCE for a calendar year and are not able to switch until the end of that calendar year. This is also referred