Frequently Asked Questions

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FREQUENTLY ASKED QUESTIONS
Remember that program questions and answers are specific to each program area and all answers do not apply to all programs.
 
Do I Qualify?
Each Medicaid program has different criteria for determining if a person or family qualifies for coverage. Eligibility could be based on income, assets, family size, medical need or a combination of these factors.
More information can be found under “Covered Services and Eligibility Overview in the drawer “Indiana Public Insurance Options” at www. Indianahealthcaretoolbox.org
 
How to Apply?
Application assistance can be received at:

http://ckfindiana.org/contact-coalitions.php
See “How to Apply” page under Hoosier Healthwise at www.Indianahealthcaretoolbox.org
You can also go to your local DFR (Department of Family Resources) office or
online at www.Healthcare.gov
 
Where is my CKF local Coalition office?
http://ckfindiana.org/contact-coalitions.php
 
If Applying at your local CKF or DFR office, what information do I need to know/take with me to apply for Medicaid?
For every person living in your household you must provide:
 

  • Birth Certificates for all persons in the home
  • Social Security Numbers for all persons in the home
  • Income from jobs or training (3-months pay statements – pay checks are not acceptable)
  • Award letters for Social Security, Supplemental Security Income (SSI), veteran's benefits, child support, Social Security Disability (SSD)
  • Proof of payments for adult or child care
  • Insurance cards for Health coverage you currently have or have had in the last 3 months
  • Proof of citizenship (if applicable)

 
 
How can I change my primary care physician (PMP)?
To change your PMP, please call your health plan (MCE) at the number listed below:
 

  • Anthem: 1-866-408-6131
  • MDwise: 1-800-356-1204
  • Managed Health Services: 1-877-MHS-4U4U or 1-877-647-4848

 
What is a health plan - Medical Care Entity (MCE)?
A health plan is a group of healthcare providers including primary care doctors, specialists, home healthcare providers, pharmacies, therapists, and so on. Each doctor is enrolled in one or more of these health plans. When you choose your doctor, you will also choose a health plan (MCE). It is important for you to know which Hoosier Healthwise health plan (MCE) you and your doctor are in because for most health care services, you must only use health care providers that are in your health plan (MCE).
 
How can I change my MCE?
You can change your health plan at certain times during the year:
1.  During the first 90 days with a new health plan/MCE.
2. During redetermination.
3.  If you file a grievance with your health plan/MCE & the State finds that you have a good reason to change health plans/MCE.
Another name for good reason to change health plans (MCE) is "just cause." You must first contact your health plan (MCE) so they can attempt to help you. If you are still unhappy after contacting your health plan (MCE) you can call the Hoosier Healthwise Helpline at 1-800-889-9949 and they will review your request.
 
 
How do I file a complaint?
Call your health plan (MCE) if you have a complaint or grievance. If you do not know which health plan you are enrolled in, please call the Hoosier Healthwise Helpline at 1-800-889-9949. The telephone numbers for all health plans (MCE) are listed below:
 

  • Anthem: 1-866-408-6131
  • MDwise: 1-800-356-1204
  • Managed Health Services: 1-877-MHS-4U4U or 1-877-647-4848

 
 
How can I request a new card?
1-800-403-0864.
 
How can I change my address?
1-800-403-0864
 
 
Who do I call if I have questions about premium payments for the Children's Health Insurance Program (CHIP) also call Medicaid Package C?
CHIP members who have questions about premium payments can call 1-866-404-7113. Premium payment checks or money orders should be mailed to:
Hoosier Healthwise
P.O. Box 3127
Indianapolis
, IN 46206-3127
 
 
I need an Authorized Representative (AR) Form.  Where can I find it?
http://member.indianamedicaid.com/resource-center/forms-library.aspx
 
 
How do I file a complaint?
If you have a complaint or grievance regarding your PMP or health plan, you need to call your health plan. The telephone numbers for the health plans are:
 

  • ADVANTAGE: 1-800-784-3981
  • MDwise: 1-800-356-1204 or 317-630-2831 in Indianapolis 
  • If you do now know which health plan you belong to, contact the enrollment broker helpline at 1-866-963-7383. This is a free call.

 
PRESUMPTIVE ELIGIBILITY (PE)
 
 
How can I apply for PE?
You can apply for PE at Federally Qualified Health Clinics (FQHCs). If you do not know where to locate a clinic, contact your local CKF office http://ckfindiana.org/contact-coalitions.php
 
CKF will direct you to a local clinic where you will have a pregnancy test. Some clinics will assist you in applying for PE and your benefits will begin that day.
 
For more information on PE, go to www.indianahealthcaretoolbox.org under Covered Services and Eligibility Overview.
 
You MUST apply for Hoosier Healthwise for your benefits to continue throughout your pregnancy.
 
 If directed to an enrollment center you will need to bring the results of the pregnancy test with you.
 
What should I bring with me to the designated clinic or doctor's office?
To have a pregnancy test and apply for presumptive eligibility (PE) you MUST provide the following{


  • Name
  • Address
  • Phone Number
  • Social Security Number
  • Number of People in Your Family
  • Dollar Amount of Monthly Family Income

 
 
How can I find a designated clinic or doctor in my area?
http://ckfindiana.org/contact-coalitions.php
 
 
Will my baby have healthcare coverage if I am covered by Medicaid for the baby's delivery?
If you have Medicaid coverage, your baby will also be covered from the day of birth.
 
If you do not have Medicaid coverage for labor and delivery, including those who had PE but did not qualify for Medicaid coverage, you must apply for Medicaid coverage for your newborn baby (the hospital can assist you with contacting CKF for application assistance).
 
You MUST apply for Hoosier Healthwise for pregnancy coverage to continue throughout your pregnancy. Make sure that you respond to all requests for information and begin Medicaid coverage before the baby is born.
 
If I qualify for PE, will I have to choose a health plan and a doctor?
Yes. You must choose your health plan and your doctor while you are at the designated clinic or doctor's office applying for PE. You will make your choice by calling the enrollment broker. The clinic or doctor's office will help you with this process while you are in their office.
 
Whom should I contact if I have more questions about PE?
http://ckfindiana.org/contact-coalitions.php
 
 
 
 

 

 
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