Page 8

An individual may not be enrolled in or eligible for enrollment in the federal Medicare program. The HIP Basic State Plan has no provision for retroactive coverage. The effective date of HIP Basic State Plan coverage begins in the month in which the 60 days to make a power account contribution has expired.5

3520.20.00 HIP PLUS-STATE PLAN WITH CO-PAYS (MED 3)

This category is identified in the Eligibility System as MAPC.

To be eligible in this category an adult must have been eligible under MASP, while being determined medically frail, having income between 100% FPL and 133%FLP, and fail to make ongoing financial contributions to a POWER account. An individual may not be enrolled in or eligible for enrollment in the federal Medicare program. There will be no lockout periods for MAPC AGs. The effective date of MAPC coverage begins in the month in which the 60 days to make a power account contribution has expired.

Note: Lockouts for non-payment of HIP Power Account Contributions were suspended effective 3/20/20 and removed from the HIP program effective 7/1/21. 3520.25.00 HIP REGULAR PLUS (MED 3)

This category is identified in the Eligibility System as MARP.

To be eligible in this category an adult must be an Indiana resident who is at least 19 years of age and less than 65 years of age. An individual may not be enrolled in or eligible for enrollment in the federal Medicare program or be eligible for any other Medicaid category.6 The income standard is 133% FPL. HIP Regular Plus requires the participant to pay a monthly POWER Account contribution (PAC) and only has co-payments on non-emergency use of the hospital emergency department. The HIP PLUS State Plan has no provision for retroactive coverage. The effective date of HIP PLUS coverage begins the first day of the month in which the individual makes an initial POWER account contribution.7

3520.30.00 HIP REGULAR BASIC (MED 3)

This category is identified in the Eligibility System as MARB.

To be eligible in this category an adult must be an Indiana resident who is at least 19 years of age and less than 65 years of age with incomes at or below 100% FPL will be enrolled in HIP Basic after failing to make financial contributions to a POWER account within 60 days of authorization.

An individual may not be enrolled in or eligible for enrollment in the federal Medicare program or be eligible under any other Medicaid category.8