What To Do If You Get a Medical Bill

MDwise only pays your provider for the covered services you get. With the exception of copays you must pay for HIP Basic and HIP State Plan Basic, a provider cannot require you, your relatives or others to pay additional charges for these covered services. 

Health care providers generally cannot bill Hoosier Healthwise or Healthy Indiana Plan members unless it is for a non-covered service. 

If you do get a bill for health care services, take care of it right away by following the steps below. Otherwise, it may be sent to a collection agency. 

  • Contact your health care provider to make sure they know you are on the MDwise Plan. 
  • Make sure the charge is not your copayment. Copayments may be billed. For a list of copayments, go to page 13 and find the copayments for your plan. 
  • If the bill is not your copayment or the copayment is wrong, contact MDwise. Make sure that you have the bill in your hand. 

Providers know the limits placed on their services. The provider must tell you if MDwise does not cover a service before the service is provided. 

A provider may charge you for services that are not covered by MDwise if: 

  • The provider told you before providing the services that the services are not covered. 
  • You agreed to pay for the service in writing. 

Remember to take your member ID card with you to all health care appointments and show it to the office staff.