Provider Manual and Overview
The MDwise provider manuals inform you about our health plans, guidelines, requirements, policies and procedures, as well as help to answer everyday questions you may have. Choose a program below to access its respective provider manual.
A health plan for children, pregnant women and low-income families.
A health plan for uninsured adults ages 19–64.
A health plan for people who have special health needs or benefit from specialized attention.
A health plan for individuals and families in need of affordable health insurance.
A care management program for people who need help using their health care benefits.
MDwise serves its Hoosier Healthwise, Healthy Indiana Plan and MDwise Marketplace members under a delivery system model. The basis of the delivery system model is the localization of health care around a group of providers. Delivery systems are mainly comprised of hospital, primary care, specialty care and ancillary providers who are closely related either in ownership or shared mission.
Integrated care is a hallmark of MDwise’s approach to improving the health status of our members and lowering total health care costs. MDwise has developed a comprehensive behavioral health network that allows members to receive the right care in one place for both primary and behavioral health care.
The Right Choices Program is a MDwise care management program for people who need help using their health care benefits. Members in the Right Choices Program receive quality health care because each member has a team to help manage their care.