Member Information for Hoosier Healthwise

Welcome to the MDwise Hoosier Healthwise plan.

Member Information

As a MDwise Hoosier Healthwise member, remember these basic rules:

  1. You can only choose and change your doctor by talking with MDwise. Call MDwise customer service right away and confirm your doctor.
  2. Carry your member ID card with you at all times. Show your card every time you get health care.
  3. Contact your doctor first for all medical care.
  4. Only go to the emergency room for true medical emergencies. Call your doctor first if you aren’t sure.
  5. Make sure MDwise always has your correct address and phone number. This will help us contact you about you and your family’s important health care information.
  6. Review your member handbook for important information
  7. Some services need approval from MDwise before you get them. This is called prior authorization. For more information see the Hoosier Healthwise member handbook (English) | Hoosier Healthwise member handbook (Spanish).

Member Handbook

The MDwise member handbook is the best place to go to understand your benefits and services. You receive this handbook when you become a MDwise member. Please review it carefully. It has a lot of important information to help you to get the health care you need.

Here is a PDF version of the handbook (English) and handbook (Spanish).

The MDwise member handbook has information about:

Member Forms

INcontrol forms:

Cost of Care

It is important to know what your medical services cost.

You may want to know the cost of a medical service before you go to the doctor. You can download and print the MDwise list of common medical services and estimated reimbursement rates (English) | MDwise list of common medical services and estimated reimbursement rates (Spanish).*

You can also call MDwise customer service at 800.356.1204. We can mail you a list of these common services and their estimated reimbursement rates. If you want to know about a specific service that is not listed, please call MDwise customer service and we will research it for you. We will call you back to let you know the estimated reimbursement for that service.

*Please note that these costs are estimates

Reporting Changes

New Address, Phone Number, Change in Income or Change in Family Size 

If you move or change your phone number, you must let the Division of Family Resources (DFR) know. You can make changes 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.

Other Insurance Plans 

If you have other health insurance, please call 1-800-403-0864 to report this.

You must let the Division of Family Resources (DFR) know if you:

  • Have a new address.
  • Change your phone number.
  • Have a change in your income.
  • Have a change in your family size.


Go to your FSSA Benefits Portal. Once you log in, you can report a change. You can also contact your local DFR office. Go to http://www.in.gov/fssa/dfr/2999.htm to find the closet DFR office near you. You can also call MDwise customer service. We can help. 

Please also call MDwise as soon as you know your new address or phone number. This helps us to tell you about special programs and important health care information.

If you or your child has other health insurance, you must let us know. You can call MDwise or your care manager. You must also tell us (or your care manager) if: 

  • You have changes in your insurance.
  • You get hurt in a car wreck.
  • You get hurt at work.
  • You get hurt and someone else may have to pay.

The other insurance plans are supposed to help pay for your care. By letting us know about them, you can help make sure they do. Telling us about your other insurance will not reduce your MDwise benefits.

If you are involved in an accident, subrogation communication should be sent to:

Multiplan
Phone: 866-223-9974
Fax: 866-297-3112
Address: 535 Diehl Road, Suite 100, Naperville, IL 60563 

Open Enrollment Period

Hoosier Healthwise members remain enrolled in their chosen health plan for a one-year period. You are in the MDwise health plan. New members get 90 days to decide if they want to stay in the MDwise plan. Once each year after that you will have an open enrollment period. During this time you will have another chance to choose a new health plan. Once the open enrollment period ends, you will stay enrolled in your chosen health plan for the rest of the 12 month period unless you lose your Hoosier Healthwise eligibility. You can still change your health plan doctor at any time. To change your doctor, please call MDwise customer service.
 

Fraud and Abuse

You can report fraud and abuse by calling MDwise customer service. You do not have to give your name. If you do, the provider or member will not be told that you called.You also can send an email to our fraud investigation team at SIU@MDwise.org, or leave us an anonymous voice message on our Compliance Hotline, 317-822-7400.

Examples of health care provider fraud and abuse are:

  • Billing or charging you for services that MDwise covers.
  • Offering you gifts or money to receive treatment or services.
  • Offering you free services, equipment or supplies in exchange for use of your Hoosier Healthwise or Healthy Indiana Plan number.
  • Giving you treatment or services that you do not need.
  • Physical, mental or sexual abuse by medical staff.
  • Billing or charging for a treatment, service or supply that is different than what you received.

Examples of member fraud and abuse are:

  • Members selling or lending their identification cards to people not covered by Hoosier Healthwise or the Healthy Indiana Plan.
  • Members abusing their benefits by seeking drugs or services that are not medically necessary.

Help MDwise Stop Fraud and Abuse

  • Do not give your member ID card or MDwise card number to anyone. It is okay to give it to your doctor, clinic, hospital, pharmacy, Hoosier Healthwise, Healthy Indiana Plan or MDwise customer service.
  • Do not let anyone borrow or use your member ID card.
  • Do not ask your doctor or any health care provider for medical care that you do not need.
  • Work with your primary doctor to get all of the care that you need.
  • Do not share your Hoosier Healthwise, Healthy Indiana Plan or other medical information with anyone except your doctor, clinic, hospital or other health provider.

If you have questions or concerns about fraud and abuse, call MDwise customer service.

Steps to Wellness Newsletter

The MDwise Steps to Wellness newsletter provides information on Hoosier Healthwise and HIP benefits. It also includes helpful tips for you and your family on how to stay healthy. A new version is published every three months.
 

2022

2021