HIP Power Account
What is a POWER Account?
(Personal Wellness and Responsibility)
Due to COVID-19, the state has stopped the collection of POWER Account contributions. It will last for as long as Indiana is experiencing a public health emergency. During this period, you will not receive a POWER account statement or invoice. Additionally, copayments will not be required for any service.
What do I need to do?
Nothing. You do not have to make payments for these months. We will notify you when you need to make payments again. You will have 60 days to make your first payment once you receive an invoice.
HIP program members will have a special savings account. This is called a Personal Wellness and Responsibility (POWER) Account. The first $2,500 of your health costs will be paid for with your POWER Account.
Fast Track to HIP
You may be eligible to join Indiana’s Fast Track program. If you are eligible, you will get a notice from the state with instructions on using the Fast Track option. Fast Track may allow you to start your benefits sooner. To learn more about Fast Track, visit the Fast Track section on the HIP Home webpage.
How to Use Your POWER Account
Your POWER Account is used each time you use services. CareSource will keep paying for your services even if you use all of the money in your POWER Account before the year ends. You must renew your eligibility every 12 months to get a new $2,500 deposited in your account each January. That money will pay health claims for the first $2,500 of your covered health care costs. CareSource keeps track of the money in your POWER Account and will send you a monthly statement.
Tracking and Rolling Over Your POWER Account
It is important to track the funds in your POWER Account. By using your POWER Account wisely, you can save on future health care costs. If your yearly health care costs are less than $2,500 per year, the amount left in your POWER Account may lower your monthly payment for the next year. This is called a rollover.
If you are a HIP Plus member, any rollover funds will be applied toward the next year’s POWER Account Contribution, reducing the amount you owe for HIP Plus next year. If you get at least one recommended preventive health care service, the state will reward you by doubling your rollover funds.
If you are a HIP Basic member, have rollover funds and get at least one recommended preventive service, you can use these rollover funds to upgrade to HIP Plus at a discounted POWER Account Contribution.
You will get a monthly statement to track your POWER Account funds. You can also see your POWER Account balance on My CareSource. One way to keep your costs down is to follow preventive care guidelines for men or women. This also can be found on your MyHealth account. For more information about rollover funds, call Member Services: 1-844-607-2829 (TTY: 1-800-743-3333), 8 a.m. to 8 p.m., Monday – Friday Eastern Time.
Using your POWER Account with HIP Basic
When you are in HIP Basic, the first $2,500 of your health care expenses each year are paid from the POWER Account. You will be responsible to pay for copays. When you need health care, you will make your copay to the health care provider and then the funds in the POWER Account will be used to pay for in-network health care services.
In HIP Basic, after you have exceeded $2,500 in covered benefits, all future covered benefits will be fully paid for; but you will still need to make the copays to the doctor or pharmacy.
Using your POWER Account with HIP Plus
The first $2,500 of your health care expenses each year are paid from the POWER Account for HIP Plus members too; however, HIP Plus members pay a small portion of their POWER account each month. This is called a POWER Account Contribution (PAC). HIP Plus members do not pay copays, except if they use the ER for non-emergencies.
The amount of your PAC varies based on where your income and family size fall on the Federal Poverty Level (FPL). It can be $1, $5, $10, $15 or $20 per member per month for an individual. HIP Plus members who use tobacco may also be charged a 50 percent increase on their PAC.
Make Payments On-Time
What happens if HIP Plus members stop paying their PAC depends on whether their income is above or below the Federal Poverty Level (FPL). Note, the FPL is updated yearly in late January. You can see the full FPL chart for more information.
HIP Plus Members
- Earning Less than FPL: If you are in HIP Plus, have an income that is less than the federal poverty level and stop making your monthly PAC, you will be moved to HIP Basic. HIP Basic does not include vision, dental or chiropractic services. You will also have to make copays for most health services you get.
- Earning More than FPL: If you are a HIP Plus member with income that is more than the federal poverty level and stop making your monthly PAC, you will lose your coverage.
HIP State Plan Plus Members
- Earning Less than FPL: If you are a HIP State Plan Plus member with income equal to or less than the federal poverty level and stop making your monthly PAC, you will be moved to HIP State Plan Basic. You will need to make a copay at each visit for medical services.
- Earning More than FPL: If you are a HIP State Plan Plus member with income above the federal poverty level and stop making your monthly PAC, your plan will be changed to HIP State Plan Plus with copays. You will need to make copays and you will keep getting billed for your monthly PAC. Copays will be required until the next redetermination period. And, in order to become eligible for HIP State Plan Plus (without copayments), your contributions must be paid to date.
Please call Member Services: 1-844-607-2829 (TTY: 1-800-743-3333), 8 a.m. to 8 p.m., Monday – Friday Eastern Time if you have questions about making payments and using your POWER Account.
Reporting a Change: Changes in household income and address must be reported to the state. You must let the Division of Family Resources (DFR) know. You can call DFR at 1-800-403-0864 or go to https:// fssabenefits.in.gov/benefitsportal/app/portalhome#/.
Employer POWER Account Contributions
Ask your employer if they offer payroll deduction for health insurance contributions. Visit CareSource.com/in/members/tools-resources/forms/Medicaid/ to get the Employer Payroll Deduction Form.
You may also call Member Services to ask for a copy of the form. Please fill out the form and send it to CareSource. CareSource will work with your employer to set up a payroll deduction. This form lets CareSource coordinate with your employer. It does not automatically enroll you in Employer Payroll Deduction.
THIRD PARTY POWER ACCOUNT Contributions
Other third parties (Churches, etc.) can contribute to your POWER Account. They can make a monthly payment or a lump sum payment up to your total yearly contribution. CareSource will apply the payment within 2 days. You are responsible for any remaining balance. Please visit www.caresource.com/hippay for more information.
- Pregnant women, Native Americans and Native Alaskans are exempt from copays and cost sharing.
- When cost sharing is more than 5 percent of a family’s household income, your out-of-pocket expenses will be reduced. You will be notified by CareSource when this happens.
- If you meet the 5 percent cost share, you will still owe $1 per month for your POWER Account Contribution until the next quarter. Members who must pay the tobacco use surcharge will owe $1.50. The state will monitor your cost share quarterly and notify you if the cost share is met. POWER Account Contribution invoices will show the amount you owe each month.
- Refunds for overpayments will be issued to members during the POWER Account reconciliation process. These are issued within 120 calendar days after the end of the member’s benefit period. Please call Member Services at 1-844-607-2829 between the hours of 8 a.m. and 8 p.m. Monday through Friday for more information on refunds and rollovers.
- Members have the right to obtain a partial refund of their POWER Account Contribution if they leave the HIP program.
- Employers and other third parties can contribute to a member’s POWER Account. Please visit caresource.com/hippay for more information.