HIP Plus vs. HIP Basic

HIP Plus is the preferred plan for all Healthy Indiana Plan (HIP) members. HIP Plus provides the best value coverage and includes more benefits.

  • HIP Plus covers more, including vision, dental and chiropractic services, bariatric surgery and Temporomandibular Joint Disorders (TMJ). It also has more visits to physical, speech and occupational therapists. Members pay affordable monthly contributions based on income and do not pay any other costs unless they visit the emergency room when they don’t have an emergency health condition.
  • Though you will have a monthly fee based on your income, in most cases this amount would be less than the amount you would pay for copayments on the HIP Basic plan.

Members Start with HIP Plus

After applying, you will receive a first invoice from CareSource for your POWER Account Contribution (PAC). After you pay the invoice, HIP Plus benefits begin on the first of the month in which you paid. For example, if you pay in January, your benefits begin in January.

Note:  HIP coverage typically starts the first day of the month when payment is made unless you are already enrolled for other coverage.

HIP Basic

What happens if you do not pay your PAC within 60 days of qualifying for HIP benefits? That depends on how your income compares to these HIP Basic limits.

  • If you are above these income limits, you will lose all HIP benefits and must wait six months to reapply.
  • If you are at or below these HIP Basic income limits, you will switch to HIP Basic benefits.
  • Remember these facts about HIP Basic:
    • HIP Basic benefits meet the requirements of minimum essential coverage but has less benefits than HIP Plus. HIP Basic does not provide coverage for vision, dental or chiropractic services, bariatric surgery or Temporomandibular Joint Disorders (TMJ). HIP Basic also has fewer visits to physical, speech and occupational therapists.
    • Copayments are required for most health services including visiting the doctor, filling a prescription and staying in the hospital. These copayments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay.
    • You could pay more on HIP Basic if you have many doctor visits, prescriptions or hospital stays.