The HIP State Plan benefits grant you comprehensive coverage including vision, dental, non-emergency transportation, chiropractic services and Medicaid Rehabilitation Option services.
What does hip insurance entail?
The Healthy Indiana Plan (HIP) is a state-sponsored insurance program in Indiana. HIP provides health care to individuals with modest incomes. Visit www.in.gov/fssa/hip for additional information about HIP income limitations. You must disclose changes to your income or household to the State.
Is Indiana Medicaid equivalent to cool?
The Healthy Indiana Plan (HIP) is the state health insurance program of Indiana. It is one of the Medicaid programs accessible to qualified Indiana citizens between the ages of 19 and 64.
Medicare pays hip replacement surgery when medically required, from “prehab” until rehabilitation. This implies that your preoperative appointments, surgery, rehabilitation, and postoperative treatment are all covered by Medicare.
Does Indiana Medicaid cover medications?
When you require prescription or over-the-counter (OTC) medications, your physician will issue you a prescription. Your physician will then call your pharmacist, or you may take the prescription to your pharmacy to obtain the medication (s). MHS is committed to providing all MHS members with appropriate, high-quality, and cost-effective medication therapy.
- MHS collaborates with providers and pharmacists to guarantee coverage for pharmaceuticals used to treat a range of illnesses and disorders.
- Sign in to your member account to access your individual pharmacy benefit information, such as your claims history, drugstore locations, and list of completed medications.
All MHS members are required to utilize an Indiana Medicaid network pharmacy, including mail-order pharmacies. Utilizing the Find a Provider function, you may locate a network pharmacy. To locate a network pharmacy:
- Click Find a Provider on the mhsindiana.com homepage.
- Click Start Searching. A new window will be created.
- Enter your zip code and choose Healthy Indiana Plan as your coverage option.
- Select Advanced Search
- In the box labeled Type of Provider, choose Pharmacy.
- Select Search
Always display your member ID card each time you fill or pick up an order from the pharmacy. Do not request a refill until you are out of a medication. Please contact your physician or drugstore a few days before to running out. MHS covers prescription and some over-the-counter (OTC) drugs when prescribed by a Medicaid-enrolled MHS practitioner in Indiana. For instance:
- FDA-approved prescription medications and over-the-counter (OTC) products (FDA). More information may be found in the sections labeled “Preferred Drug List” and “Over the Counter Drug List.”
- Self-injectable medications (including insulin).
- There are medications that assist you quit smoking.
In addition, your pharmacy will have needles, syringes, blood glucose monitors, test strips, lancets, and glucose urine testing strips. Not all drugs are covered by the pharmacy program. Certain drugs require prior permission (PA) or have age, dose, and quantity restrictions.
- Your pharmacy coverage is equipped with a Preferred Drug List (PDL).
- The PDL applies to medications obtained through retail pharmacies.
- These are the medications we recommend your doctor prescribe.
- Four times every year, a team of doctors and pharmacists revises this list.
- This list is updated to verify that the medications are safe, effective, and cost-effective for the Indiana Medicaid program.
The HIP Plus PDL offers a variety of medications for the treatment of most diseases. This list contains both generic and brand-name medications. Some medications will be covered only with prior permission. If you have HIP Plus, you will not be required to pay a copayment for your medications.
- HIP Plus (PDF)
- HIP State Plus (PDF)
- HIP Basic (PDF)
- HIP State Basic (PDF)
Control + F to search within the PDL Drug Search Tool When your physician has approved generic medications, your pharmacist will provide them to you. Generic medications are identical to brand-name pharmaceuticals and reduce the cost of healthcare. If no generics are available, you may be prescribed brand-name medications.
- When available for your medical condition, generic and preferred medications must be utilized unless your doctor presents a medical cause for you to use a different prescription.
- Some over-the-counter medications are covered by Indiana Medicaid.
- Even listed OTC medications require a prescription for coverage.
The OTC Drug Formulary may be found in any of the PDL options listed on this page.
- HIP Plus does not need copayments for drugs.
- HIP Basic – A copayment is required for all drugs.
Specialty medications are typically prescribed for the treatment of complicated medical diseases and require special storage and handling procedures. Frequently, these drugs are expensive and injectable. These prescriptions must be filled at the speciality pharmacy of our choosing.
On the PDL, the letter “S” appears next to the name of the specialized medication. MHS may require prior authorization for some medications. If you require a prescription that requires prior permission, you or your doctor will be required to give information about your health so that MHS can determine whether or not to pay for the drug.
MHS covers some speciality pharmaceuticals administered intravenously at a doctor’s office or clinic, as well as some specialty drugs administered orally. Before MHS will cover certain medications, they must be authorized by MHS. The list of speciality medications may be found on our website.
- On the PDL, a medicine is designated as non-preferred if specific requirements must be satisfied before to administration.
- You are receiving a larger dosage than is typically prescribed.
- Other medications are suggested to be tried first.
In the majority of circumstances, you may obtain a three-day (72-hour) supply of a medicine requiring prior permission while you wait for a decision. Within one day (24 hours), a decision will be made and you and your physician will be contacted. Our prior permission forms (including speciality forms) are available for download on our Provider Forms page.