Open Enrollment for the Marketplace at HealthCare.gov officially ended on March 31st though it was extended until April 15th for anyone who “attested” they had made an attempt to enroll prior to the deadline. Individuals who qualify for a “Special Enrollment Period” will now be permitted to enroll in a subsidized health insurance plan, though each application must be approved by the Marketplace. Indiana continues to negotiate the use of the Healthy Indiana Plan (HIP) as a mechanism to expand Medicaid. Our goal remains to provide you and your patients / clients / consumers with the ClaimAid Advantage.

Enrollment still available for uninsured via HealthCare.gov

  • The first “Open Enrollment” period has ended, but enrollment is still available for many uninsured.
  • What you need to know:  More than half of the individuals enrolled in Medicaid or a Marketplace plan in Indiana are expected to have an “event” that may qualify for a “Special Enrollment Period” throughout the calendar year.  The Marketplace will determine whether or not the individual’s circumstance will be approved for enrollment based on the explanations in their application. If you or your patients / clients have questions about a change in circumstance or enrolling outside of Open Enrollment, you may direct them to a ClaimAid advocate or CONTACT US.

Indiana Medicaid Expansion and Leadership change at U.S. Health & Human Services

  • HHS Secretary Kathleen Sebelius has resigned her position and President Obama has nominated White House budget office director Sylvia Matthews Burwell for a replacement.
  • What you need to know: At this time, Governor Mike Pence’s office has stated they have no reason to believe the discussions regarding using the Health Indiana Plan (HIP) for Medicaid expansion will change with the new secretary. The state of Indiana is presently waiting to receive a decision from federal officials with respect to the proposal of using the Healthy Indiana Plan, rather than traditional Medicaid Program, to provided expanded coverage to uninsured Hoosiers.

New Hospital Presumptive Eligibility (HPE) Program Processes Detailed

  • The State of Indiana’s Office of Medicaid Policy and Planning (OMPP)  has released additional details regarding Hospital Presumptive Eligibility (HPE) processes
  • What you need to know:  Indiana FSSA has released a new “2014 IHCP Hospital Presumptive Eligibility (HPE) Process Summary” that may be located HERE. The one page document details aid categories, income limits and application requirements. Recent guidance from FSSA and CMS also permits contract staff to assist with HPE operations as long as the hospital takes responsibility for the presumptive eligibility (PE) determinations that result.” Official IHCP Banner information may be found by clicking HERE. If you have questions or would like more information on this new program, please CONTACT US.

For more details and up-to-date information, please contact J Hopkins, Vice President at 800.842.4052 x126 or by email at jhopkins@claimaid.com.