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POWER Account | HIP

POWER Account - Healthy Indiana Plan

A POWER Account is similar to a deductible. It is the amount you have to pay before the insurance company will cover the remaining costs.

POWER Accounts are funded in an amount equal to $2,500 for every HIP member.

Your POWER Account Contribution is going to be 1 of 5 amounts, depending on your household income. This is measured by a comparison to the Federal Poverty Level (or FPL). For example, if you make 48% of the FPL, or about $1,000 per month for a family of four, you would pay $5 per month.

FPL Monthly PAC Single Individual Monthly PAC Spouses PAC with Tobacco Surcharge Spouse PAC when one has tobacco surcharge Spouse PAC when both have tobacco surcharge (each)
< 22% $1.00 $1.00 $1.50 $1.00 & $1.50 $1.50
23-50% $5.00 $2.50 $7.50 $2.50 & $3.75 $3.75
51-75% $10.00 $5.00 $15.00 $5.00 & $7.50 $7.50
76-100% $15.00 $7.50 $22.50 $7.50 & $11.25 $11.25
101-138% $20.00 $10.00 $30.00 $10.00 & $15.00 $15.00

The POWER Account is funded through one or more of the following:

MDwise POWER Account features include:

  • A member’s POWER Account is used to pay the first $2,500 of HIP covered services.
  • Preventive care services are free and are not deducted from the POWER Account.
  • Members may not use their POWER Account to pay for ER copayments.
  • HIP Basic members may not use their POWER Account to pay for copayments for medical services.
  • No POWER Account contributions or any other cost-sharing, including copayments for non-urgent ER visits, will be expected from pregnant members.

Attention HIP members: If you use tobacco, you have 12 months to stop tobacco use or you may have a higher POWER Account contribution. If you don’t stop using tobacco, your POWER Account contribution payment may have a 50 percent surcharge. Example: If your current monthly POWER Account contribution is $10 a month, if you do not stop the use of tobacco in 12 months of your coverage starting, your contribution may go up to $15 the next year.

Tobacco use means the use of tobacco 4 or more times a week in the last 6 months. This includes the use of chewing tobacco, cigarettes, cigars, pipes, hookah and snuff. It does not include the use of nicotine delivery devices.

If your tobacco status changes or if you feel we have wrong information about your tobacco status, please call MDwise customer service.

As a member of the Healthy Indiana Plan, there are special rules to follow. Once you are eligible for the Healthy Indiana Plan, you will get a letter that will let you know what your monthly contribution is. You must pay this each month.

After you make your initial contribution, the Healthy Indiana Plan will add the State portion of the funds you will need to get health care services. This money will go into your POWER Account. Healthy Indiana Plan members are responsible for a share of the POWER Account deductible. You may have debt to MDwise by using the POWER Account before the account is funded. Please see our POWER Account policy: HIP Debt Collection Policy.

Members on HIP Basic cannot return to HIP Plus until their next eligibility period. If you move or change your phone number, you must let the Division of Family Resources (DFR) know. You can do this online here. Log in to the system to make your change. If you don't have a login, click on the blue "sign up for a new account" button. You can also call 1-800-403-0864 to make the change.

Rollover

Once you become fully eligible and renew your coverage, the following steps are taken to settle your $2,500 POWER Account from the prior period to the State:

  1. MDwise will gather your benefit period and enrolled covered months.
  2. If you were a HIP Plus member, MDwise will gather all contributions paid into the POWER Account by you, your employer, any third-party entity on your behalf and the State.
  3. MDwise will gather all claims paid from the POWER Account and determine whether or not you had preventive services.
  4. If your POWER Account has $0 value, no further action is needed. However, if there is a positive balance left over in your account, MDwise will run the rollover process.

Members ending their prior benefit period as HIP Plus:

  • Member Rollover - You get to use these dollars to reduce the amount owed for your current benefit period. Member Rollover dollars can be used to pay off existing debt on account or to pay tobacco surcharge amounts. Member rollover earnings are limited to a maximum of $240 or as a tobacco surcharge member they may earn up to $360 in member rollover. Excess member rollover are refunded to the member.
  • State Rollover - If you also received preventive services, the State matches your member rollover dollar amount and provides extra funds for you. These funds will be used to further reduce the amount you owe for the current benefit period but only after member rollover dollars are used up. State Rollover is NEVER used to pay tobacco surcharge amounts.

Member ending their prior benefit period as HIP Basic:

  • State Rollover Discount Percentage - If you also received preventive services, you will earn a state discount equal to the percentage of funds left over in your POWER Account. The maximum discount percentage is 50 percent. The discount is applied to reduce the POWER Account contribution due to move you from the HIP Basic to the HIP Plus plan. If you choose NOT to pay for HIP Plus at this reduced rate, the State's rollover discount is lost for the rest of the current benefit period. HIP Basic members who do NOT get preventive services will not earn the State rollover discount.

Reminder: If you are a HIP Plus member and you do not make your POWER Account payment, you may be disenrolled or moved to HIP Basic, depending on your income. We will send you a statement each month to remind you a payment is due. There will be a 25% penalty on the remaining balance of your contributions in your POWER Account.

Members on HIP Basic cannot return to HIP Plus until their next eligibility period. If you move or change your phone number, you must let the Division of Family Resources (DFR) know. You can do this online here. Log in to the system to make your change. If you don't have a login, click on the blue "sign up for a new account" button. You can also call 1-800-403-0864.