What Is Covered by Hoosier Healthwise?
This is a general description of the benefits and services
available in the Hoosier Healthwise program. Please remember that
your health plan may offer additional services. The benefits
covered by Hoosier Healthwise include preventive care (like
well-baby and well-child care and regular check-ups) and mental
health and substance abuse treatment. Hoosier Healthwise also
has benefits for children with special health care needs like
asthma or diabetes.
Note: There are some benefit limits for Hoosier Healthwise
Package C members.
|
Benefit
|
Package A
|
Package C
|
|
Hospital Care
|
Yes
|
Yes
|
|
Doctor Visits
|
Yes
|
Yes
|
|
Check ups
|
Yes
|
Yes
|
|
Well-child Visits
|
Yes
|
Yes
|
|
Clinic Services
|
Yes
|
Yes
|
|
Prescription Drugs
|
Yes
May have a $.50-$3.00
co-payment
|
Yes
$3 co-payment for generic, compound,
and sole-source drugs.
$10 co-payment for brand-name
drugs.
|
|
Over-the-Counter Drugs
|
Yes
|
Over-the-counter drugs are not
covered by Package C.
|
|
Lab and X-ray Services
|
Yes
|
Yes
|
|
Mental Health Care
|
Yes
|
Yes
|
|
Substance Abuse Services
|
Yes
|
Yes
|
|
Medical Supplies and Equipment
|
Yes
|
Yes
|
|
Home Health Care
|
Yes
|
Yes
|
|
Nursing Facility Services
|
Yes
|
Nursing Facility Services are not
covered by
Package C.
|
|
Dental Care
|
Yes
|
Yes
|
|
Vision Care
|
Yes
|
Yes
|
|
Therapies
|
Yes
|
Yes
|
|
Hospice Care
|
Yes
|
Not Covered
|
|
Transportation
|
Yes
May have a $.50-$3.00
co-payment
|
Ambulance transportation for
emergencies and between medical facilities.
$10 co-payment for ambulance
transportation.
|
|
Family Planning Services
|
Yes
|
Yes
|
|
Nurse Practitioner Services
|
Yes
|
Yes
|
|
Nurse Midwife Services
|
Yes
|
Yes
|
|
Foot Care
|
Yes
|
Routine foot care services are not
covered.
Surgical procedures, lab or x-ray
services, and hospital stays involving the foot are covered.
|
|
Chiropractors
|
Yes
|
Yes
|
If you need to know if a specific procedure or service is
covered, ask your doctor or call your health plan. Some
specialized services require that you see or call your doctor
before you receive them, which is also called a referral. See
the list below to see services you can get
without calling the doctor first:
Covered Services Not in Need of
the Doctor's Referral.
- Dental care
- Podiatrist care (foot care)
- Chiropractic care
- Eye care (except surgery)
- Mental health services
- Substance abuse services
- Transportation service
If you need any other special service or would like to see
another type of medical professional, you do need to talk with your
doctor to get a referral. Some services will require your
doctor (or other special provider) to request a Prior
Authorization(PA) before the service can be delivered. It is
up to the provider to request the PA.