As governor of Indiana, Vice President Mike Pence refused to expand Medicaid in his state unless recipients could be charged. Under the Healthy Indiana Plan (HIP)those getting health insurance from Medicaid expansion must join Healthy Indiana Plus (HIP Plus). Everyone enrolled in HIP Plus must pay a monthly premium. The cost of an individual’s monthly premium for HIP Plus ranges from $1 to $27 a month.
In order to qualify for expanded Medicaid, an individual cannot earn more than 138 percent of the federal poverty level. In 2017, an individual with an income of $16,642.81 doesn’t qualify for Medicaid.
If an individual enrolled in HIP Plus through Medicaid expansion misses one payment, they are barred from accessing Medicaid services for six months.
A study showed that more than half of those required to pay for HIP Plus missed at least one monthly premium. Some of those who missed a payment were, based on their new lower income, put in the HIP. So, they didn’t lose coverage.
HIP, traditional Medicaid in Indiana, doesn’t cover dental or vision services and charges copays. If someone with traditional Medicaid in Indiana wants dental and/or vision coverage, they must pay the fees associated with HIP Plus. This means that an individual with an income of less than $12,060 must pay additional fees if they need dental or vision services, or if they want to avoid copays.
This article fact checks Indiana’s claims about the success of HIP Plus.
Seema Verma, who designed HIP Plus, is now the head of the Centers for Medicare and Medicaid Services. In her role, she has the power to let other states design plans like those she created in Indiana.
Verma was paid nearly five million dollars over four years to design HIP Plus.