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HIP Dental Plans | HIP Dental Coverage Breakdown

The Healthy Indiana Plan ( HIP ) is Indiana’s Medicaid program based individual and family income, and it has different levels of coverage based on the specific plan and eligibility. Here’s a breakdown of the differences between HIP , HIP State Plan , and HIP State Plan Plus in terms of dental coverage : HIP Basic Extremely Limited dental coverage (typically emergency-only services like extractions and pain management). Does not include routine cleanings, exams, or restorative care (fillings, crowns, etc.). For those who do not make POWER Account contributions. Not recommended for individuals needing dental work . HIP Plus Provides comprehensive dental benefits , including preventive, restorative, and emergency care. Available to members with certain medical conditions or disabilities who qualify for enhanced benefits. Works similarly to traditional Medicaid coverage. There is a $4 copay for all dental work performed. There are a number of ...

Indiana Medicaid Dental Coverage | HIP Dental Coverage

Indiana's Medicaid dental programs offer varying dental benefits tailored to specific populations. Here's a breakdown of dental coverage across the different plans: Traditional Medicaid : This program provides dental services primarily for individuals who are aged, blind, or disabled. Covered services include: Diagnostic and preventive care (e.g., exams, cleanings) Restorative services (e.g., fillings) Extractions Prosthetic services (e.g., dentures) Specific coverage details and limitations can vary, so it's advisable to consult the Indiana Medicaid member handbook or contact Member Services for precise information. Healthy Indiana Plan (HIP) : Designed for adults aged 19-64, HIP offers different dental benefits based on the specific plan: HIP Basic : This plan offers extremely limited emergency dental benefits , and is primarily an emergency based plan: HIP Plus : Members making monthly contributions receive comprehensive dental benefits, including: Two oral e...

Types of Indiana Medicaid | HIP Plans Explained

Indiana offers several Medicaid programs tailored to meet the diverse healthcare needs of its residents. Here's an overview of the key programs: Traditional Medicaid : This program provides comprehensive health coverage for individuals who are aged, blind, disabled, or meet other specific eligibility criteria. It covers a wide range of services, including doctor visits, dental care , hospital care, prescriptions, and more. Healthy Indiana Plan (HIP) : Designed for adults aged 19 to 64 with incomes up to 138% of the federal poverty level (FPL), HIP emphasizes personal responsibility and preventive care. Members contribute to a Personal Wellness and Responsibility (POWER) account, which is used to pay for initial medical expenses. Within HIP, there are several plan options: HIP Basic : Available to individuals with incomes below 100% FPL who do not make POWER account contributions. This plan covers essential health services but requires copayments for most services. It include...

Traditional Medicaid vs HIP Enrollment Numbers | Indiana State Insurance

As of June 2023, Indiana's Medicaid program serves approximately 2.23 million members . Within this population, the Healthy Indiana Plan (HIP) accounts for about 789,556 members , representing roughly 35% of the total Medicaid enrollment. The remaining 65% —approximately 1.44 million members —are enrolled in other Medicaid programs, often referred to as Traditional Medicaid . It's important to note that Traditional Medicaid encompasses various programs targeting specific groups, including: Hoosier Healthwise : Designed for children and pregnant women. Hoosier Care Connect : Aimed at the elderly and individuals with disabilities. Healthy Indiana Plan : Designed for adults and families based on income levels Other specialized programs : Serving distinct populations with unique healthcare needs. Each of these programs has its own eligibility criteria and benefit structures, tailored to meet the diverse needs of Indiana's Medicaid beneficiaries. For the most current and ...

Traditional Medicaid & HIP Breakdown | State Dental Insurance

In Indiana, Traditional Medicaid and the Healthy Indiana Plan (HIP) are both state-run health insurance programs, but they serve different populations and offer different benefits. Here’s how they compare: 1. Eligibility Traditional Medicaid : Covers low-income individuals who meet specific eligibility criteria, including: Children under 19 years old Pregnant women Elderly individuals ( 65+ years old ) People with disabilities Certain parents or caretakers of children Healthy Indiana Plan (HIP) : Covers low-income adults (19-64 years old) who do not qualify for traditional Medicaid and earn up to 138% of the Federal Poverty Level (FPL) . It is Indiana’s version of Medicaid expansion under the Affordable Care Act (ACA). 2. Cost & Contributions Traditional Medicaid : Usually free or very low-cost for members. There are no monthly premiums or required payments for most services. HIP : HIP Plus members pay monthly POWER Account contributions (similar to premiums) based...

Healthy Indiana Plan Update | 2025 HIP Latest

If the proposed cap on Healthy Indiana Plan (HIP) enrollment at 500,000 members becomes law, it could have several major effects: 1. Loss of Coverage for Hundreds of Thousands Currently, HIP enrollment is around 789,556 members (as of mid-2023). A cap at 500,000 means nearly 300,000 Hoosiers could lose access to this Medicaid expansion program. 2. Reduced Access to Dental and Healthcare Services HIP Plus provides dental benefits , especially in HIP State Plus plans , which cover cleanings, exams, fillings, and more. Those who lose HIP coverage may no longer have access to affordable dental care , potentially leading to worse oral and overall health outcomes . Fewer Medicaid-covered patients might also affect dental practices that rely on HIP patients , possibly reducing participation from providers. 3. Increased Uncompensated Care & ER Visits Without HIP coverage , many low-income Hoosiers might turn to emergency rooms for dental and medical issues , leading to hig...