IHCP recently announced that beginning April 1, 2017, MDwise will no longer be a managed care health plan option for Hoosier Care Connect members. Hoosier Care Connect members currently enrolled with MDwise have already started receiving notices from the Office of Medicaid Policy and Planning informing them of this change. Read the full IHCP bulletin here.
What you need to know:
- Members will need to select another managed care entity (MCE) – either Anthem or Managed Health Services (MHS) – for their Hoosier Care Connect benefits.
- Each member affected should have or will be receiving a letter this month offering them to make the change. If they do not make the request by 3/15 they will be auto assigned to be effective 4/1/2017. If a member is unhappy with their assigned plan and wishes to change, they will have the opportunity to change MCEs until 8/1/2017.
- Providers currently serving Hoosier Care Connect members enrolled with MDwise should direct those members to the Hoosier Care Connect Helpline at 1-866-963-7383 for health plan information. Providers may want to make their patients aware of their participation in one or both of the MCE networks from which the members must choose.
- This only affects those under Hoosier Care Connect members (see below).
Individuals in the following eligibility categories who do not reside in an institution, are not receiving services through a home and community-based services (HCBS) waiver, and are not enrolled in Medicare will be enrolled in Hoosier Care Connect:
- Aged individuals (age 65 and over)
- Blind individuals
- Disabled individuals
- Individuals receiving Supplemental Security Income (SSI)
- Individuals enrolled in Medicaid for Employees with Disabilities (M.E.D. Works)
Children who fit the following descriptions may voluntarily enroll in Hoosier Care Connect:
- Wards of the State
- Foster children
- Former foster children
- Children receiving adoption assistance Member Eligibility and Benefit Coverage Section
Individuals will be removed from the Hoosier Care Connect program and transitioned to another IHCP program if they:
- Become eligible for Medicare
- Enter a nursing home for a length of stay greater than 30 days
- Enter a state psychiatric facility, a psychiatric residential treatment facility (PRTF), or an intermediate care facility for individuals with intellectual disabilities (ICF/IID)
- Begin receiving hospice benefits in an institutional setting
- Become eligible for and choose to enter an HCBS waiver program.