Hoosier Healthwise

Hoosier Healthwise is part of Indiana’s Medicaid program. It is administered by the Office of Medicaid Policy and Planning (OMPP) and the Children’s Health Insurance Program (CHIP), both housed under the Indiana Families and Social Services Administration (IFSSA).

Hoosier Healthwise offers three benefit packages:

• Package A for people on Temporary Assistance for Needy Families (TANF), or welfare, and for those covered under the State Children’s Health Insurance Program (SCHIP), with incomes up to 150 percent of the Federal Poverty Level (FPL).
• Package B for pregnant women with incomes up to 150 percent of the FPL.
• Package C for people covered by SCHIP with incomes 150 percent to 200 percent of the FPL.

As of 2005, the federal poverty level was $9,570 for a family of one; $12,830 for a family of two; $16,090 for a family of three; and $19,350 for a family of four.

Hoosier Healthwise delivers health care in two ways: Primary Care Case Management (PCCM) and Risk-Based Managed Care (RBMC). As of June 2003, Hoosier Healthwise covered 464,407 people -- 225,876 in Primary Care Case Management and 238,531 in Risk-Based Managed Care.

PCCM is also called PrimeStep. Under this program, primary care doctors bill the state on a fee-for-service basis, plus they receive an extra fee to manage care for their Medicaid patients.