FSSA announced earlier this year that they would be adding a fourth Managed Care Entity (MCE) as an option for HHW and HIP members. Upon successful completion of the readiness evaluation, the MCE options will be Anthem, CareSource, MDwise, and MHS.
Since CareSource is a new MCE, you will need to confirm with your facilities whether or not they have enrolled with the MCE and if so, which programs – It could be for Marketplace, HIP, HHW, or all of them. Please inquire with your hospital contact to see if they are enrolling with CareSource. If you have questions about who to ask, please contact your manager.
CareSource will not be one of the MCEs for Hoosier Care Connect members (those on Aged, Blind and Disabled).
FSSA will hold a special enrollment period for HHW members starting November 15, 2016 through December 15, 2016. For members who choose new health plans during this open enrollment, the changes will take effect on January 1, 2017. If members do not wish to choose a new health plan or do not make a change by December 15, 2016, they will remain with their current health plan and will not have another opportunity to change plans until the next open enrollment period. More details can be found in this IHCP bulletin.
Members may start receiving letters from the FSSA (click here for example) along with the new HHW health plan summary. Please print the health plan summary and have it available at your desk for patients to review.
HIP members will be able to switch to any of the four MCEs at their annual eligibility renewal period.
When assisting patients with their MCE option, it is imperative that you ask the patient to confirm that the provider (doctor or other health care facility) of their choice is enrolled in the plan and is accepting them as a patient. You may need to assist them in calling the provider.
Remember, Advocates cannot choose the MCE for the patient.
Click here for tips on helping patients choose a MCE.
Effective January 1, 2017, any HHW or HIP applicant who does not select a MCE on the Indiana Application for Health Coverage will be auto-assigned to CareSource, with a few exceptions.