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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.

What are the premiums for Hoosier Healthwise Package C?

If your child qualifies for Hoosier Healthwise Package C, you will be required to pay a small premium for services.  The below table summarizes the monthly premiums based on the number of children you have and your monthly income as a percentage of the Federal Poverty Level (FPL):

Hoosier Healthwise Package C Premiums
Number of Children 175%
FPL
200%
FPL
225%
FPL
250%
FPL
1 $   22.00 $    33.00 $    42.00 $    53.00
2 or more $   33.00 $    50.00 $    53.00 $    70.00