Hoosier Healthwise FAQ
How can I change my primary care physician (PMP)?
To change your PMP, please call your health plan at the number
listed below:
- Anthem: 1-866-408-6131
- MDwise: 1-800-356-1204
- Managed Health Services: 1-877-647-4848
What is a health plan?
A health plan is a group of health care providers, including
primary care doctors, specialists, home health care providers,
pharmacies, therapists, and more. Each doctor is enrolled in one or
more of these health plans. When you choose your doctor, you will
also choose a health plan. It is important for you to know which
Hoosier Healthwise health plan 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.
How can I change my health plan?
You can change your health plan at certain times during
the year:
1. Any time during your first 90 days with a new health
plan.
2. Annually during your open enrollment period.
3. Anytime you file a grievance with your health plan, and the
State finds that you have a good reason to change health plans.
Another name for a good reason to change health plans is "just
cause." You must first contact your health plan so they can attempt
to resolve your concern. If you are still unhappy after contacting
your health plan, 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 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 are listed below:
- Anthem: 1-866-408-6131
- MDwise: 1-800-356-1204
- Managed Health Services: 1-877-647-4848
Can I choose a doctor for my baby before the birth?
Yes, you should choose a doctor before your baby is born. You
will need to choose a doctor in your current health plan. If you do
not choose a doctor before the baby is born, one may be assigned to
you.
Do I have to get my doctor to approve all of my health care
services?
There are some types of services that you can go to on your own
without seeing your personal doctor first. These include basic eye
care (eye surgeries require a doctor's approval), dental services,
foot care, chiropractic services, and family planning. However,
some services need a referral from your doctor.
Examples include going to the hospital or needing to see a
specialist.
What if I need medical attention and my doctor's office is
closed?
Make sure you get the number where you can reach your doctor
after hours. A qualified medical professional is available to you
24 hours a day to give you medical advice and tell you what you
should do in each situation. Never go to the emergency room unless
you have a true emergency. True emergencies are when a delay in
treatment would result in lasting injury or death. Some examples
are chest pain, broken bones, bleeding that cannot be stopped, or
drug overdoses. You can also call your health plan 24 hours a
day.
How can I request a new card?
If you need to request a new card, please call or visit your DFR
caseworker. If you do not have a caseworker, call
1-800-403-0864.
How can I change my address?
It is very important that you keep your address updated. If
you have a change of address or phone number, it is critical for
you to inform your DFR case manager or contact your local Division of
Family Resources office so that you will receive important
notifications.
What do I do if I need to miss or have missed a doctor
appointment?
If you need to miss a scheduled appointment with a provider, you
need to call the doctor's office as far in advance as possible.
Most offices consider 24-48 hours notice as acceptable. If you
remember that you have missed an appointment after the appointment,
you should call your doctor's office to apologize, explain why the
appointment was missed, and reschedule.
Who can I call if I receive a bill from my doctor?
If you receive a bill from your doctor, you should call your
health plan.
- Anthem: 1-866-408-6131
- MDwise: 1-800-356-1204
- Managed Health Services: 1-877-647-4848
If you receive a bill from your dentist, you should call
1-800-457-4584.
Who do I call if I have questions about premium payments for
the Children's Health Insurance Program (CHIP)?
If you are a new CHIP member, you will be mailed a premium
invoice shortly after you are determined eligible. 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
Is it true that I can go to ANY doctor as long as that doctor
accepts Hoosier Healthwise or Medicaid?
No. When you join Hoosier Healthwise,
you must choose a doctor within 30 days, or one will be assigned to
you. You must see this doctor for all your care. He or she
will refer you to another doctor if you need specialty care.
Call the Hoosier Healthwise Helpline at 1-800-889-9949 to pick your
doctor.