What Is Hoosier Healthwise?

Hoosier Healthwise is a program of the state of Indiana to provide health insurance for pregnant women, low-income families and children within the state. The program is administered by the Family and Social Services Administration. The program is intended to provide preventative and primary health care services through a Primary Medical Physician.

Who Qualifies

• Hoosier Healthwise offers five programs, each with its own income limitations. The packages include a Low-Income Family option, two programs offering coverage for pregnancy-related issues and two programs for children of low income families. The income guidelines for all five programs are available at www.in.gov/fssa/ompp.2997.htm. The number of children used in the calculation includes unborn children and children up to18 years old living with their parents or disabled people up to age 20 living with a caretaker. Individuals not American citizens may be eligible depending on immigration status.

Cost

• Some programs within Hoosier Healthwise do have a cost to the individual. The costs are based on the number of members in the family and their income and range from $22 to $50 per month. Co-payments, a portion of the cost of the health care paid by the individual, are also applicable in some cases. Information furnished by the Hoosier Healthwise program at the time of enrollment details all costs.

Coverage

• Health care procedures covered by Hoosier Healthwise vary with the program. For some coverage is limited to pregnancy related issues while the programs dedicated to children cover most health care issues for them but do not provide any coverage for the parents. Patients are urged to consult with their PMP regarding any coverage questions.

Referrals

• Hoosier Healthwise allows self-referral, the patient directly scheduling care with a specialist, for dental, chiropractic, optometrist, mental health and substance abuse treatment and podiatrist care. Patients are asked to get a referral for surgical and emergency care from their PMP. However, the Hoosier Healthwise says that in the case of true emergencies, broken bones or life-threatening bleeding for example, the PMP can be contacted by emergency room staff.

Preventative Care

• The Hoosier Healthwise program offers a checkup for all covered family members at the time of enrollment in the program. The PMP is responsible for providing or coordinating care for most medical conditions including pregnancy. The PMP is responsible for arranging any specialist care required by any member covered by the Hoosier Healthwise program.