Managed Health Services (MHS) is a health insurance provider that has served Indiana residents for over 25 years. As a healthcare entity, MHS provides coverage through various state-sponsored programs and the health insurance marketplace. This guide explains the different plans available, the benefits provided, and how you can navigate your coverage with ease.
Whether you are looking for information on the Healthy Indiana Plan (HIP), Hoosier Healthwise, or Ambetter, MHS Indiana offers a range of services designed to improve community health. Understanding how these plans work is the first step toward getting the medical care you and your family need.
What is MHS Indiana?
MHS Indiana is a managed care entity that works in partnership with the State of Indiana. They are a subsidiary of Centene Corporation, a large healthcare enterprise that focuses on government-sponsored health programs.
MHS is not just an insurance company; they coordinate care between doctors, hospitals, and pharmacies. Their primary goal is to provide high-quality, cost-effective healthcare to Indiana members through a large network of local providers.
Types of MHS Indiana Health Plans
MHS offers several different types of insurance plans depending on your income, age, and health needs. Most of these plans are part of Indiana’s Medicaid program, but they also offer private options through the marketplace.
Healthy Indiana Plan (HIP)
The Healthy Indiana Plan, commonly known as HIP, is a health insurance program for uninsured Indiana residents between the ages of 19 and 64. Eligibility is based on income levels relative to the federal poverty line.
HIP offers two main tiers of coverage: HIP Plus and HIP Basic. HIP Plus provides more comprehensive benefits, including vision and dental, while requiring a small monthly contribution to a Power Account. HIP Basic is available for those who do not make contributions but offers more limited benefits.
Hoosier Healthwise
Hoosier Healthwise is a statewide program that provides health coverage for children up to age 19 and pregnant women. This plan ensures that children have access to essential medical services during their most critical years of development.
The program covers a wide range of services including doctor visits, prescription drugs, and hospitalizations. For pregnant women, it focuses on prenatal and postpartum care to ensure healthy outcomes for both mother and baby.
Hoosier Care Connect
Hoosier Care Connect is a program specifically designed for individuals who are aged, blind, or disabled. This plan provides specialized care coordination to help members manage complex health conditions and disabilities.
Members in this program receive personalized support to help them navigate the healthcare system. This includes assistance with finding specialists, managing medications, and accessing community resources.
Ambetter from MHS
Ambetter is the brand name for MHS’s Health Insurance Marketplace products. Unlike the Medicaid-based programs mentioned above, Ambetter is private insurance for individuals who do not qualify for Medicaid but still need affordable coverage.
Ambetter plans are often eligible for federal subsidies, which can lower monthly premiums. These plans offer essential health benefits like emergency services, maternity care, and mental health support.
Key Benefits of MHS Indiana
Regardless of which MHS plan you have, there are several core benefits designed to keep you healthy. MHS focuses on preventive care to stop health issues before they become serious problems.
- Primary Care Services: Coverage for regular checkups, wellness exams, and screenings.
- Prescription Drugs: A comprehensive list of covered medications (formulary) available at local pharmacies.
- Behavioral Health: Access to mental health counseling, substance abuse treatment, and therapy.
- Maternity Care: Specialized programs like “Start Smart for Your Baby” to support expectant mothers.
- Telehealth: The ability to speak with a doctor via phone or video for non-emergency issues.
The My Health Pays Rewards Program
MHS Indiana offers a unique incentive program called “My Health Pays.” This program rewards members for taking proactive steps toward their health.
Members can earn rewards by completing specific activities, such as getting an annual wellness visit or a flu shot. These rewards are typically loaded onto a prepaid Visa card that can be used at various retailers for everyday items like groceries or utilities.
This program is a great way for members to save money while staying on top of their medical needs. It encourages a partnership between the member and their healthcare provider.
How to Find a Doctor in the MHS Network
To ensure your medical costs are covered, you must visit healthcare providers that are part of the MHS network. Finding a local doctor is a straightforward process using the online tools provided by MHS.
- Visit the MHS Indiana website and look for the “Find a Provider” tool.
- Enter your zip code and select the specific health plan you are enrolled in.
- Filter your search by the type of doctor you need, such as a pediatrician or a cardiologist.
- Review the list of providers and contact their office to confirm they are accepting new MHS members.
Always remember to bring your MHS member ID card to every appointment. This ensures the office has the correct billing information and can verify your coverage instantly.
Managing Your MHS Account Online
MHS provides a secure member portal that allows you to manage your health insurance from your computer or smartphone. Creating an account is highly recommended for all members.
Through the portal, you can request a new ID card if yours is lost or damaged. You can also view your claims history, check your My Health Pays balance, and change your Primary Medical Provider (PMP) if necessary.
The MHS mobile app is another helpful tool. It provides digital access to your ID card and allows you to find nearby urgent care centers quickly when you are away from home.
How to Apply for MHS Indiana Coverage
If you are not currently a member but believe you qualify for MHS through a state program, you must apply through the Indiana Family and Social Services Administration (FSSA). MHS does not handle the initial eligibility determination.
You can apply online at the FSSA website, by mail, or in person at a local Division of Family Resources (DFR) office. During the application process, you will have the opportunity to choose MHS as your managed care provider.
If you are applying for an Ambetter plan, you should visit the federal Health Insurance Marketplace at Healthcare.gov. During the open enrollment period, you can compare Ambetter plans and see if you qualify for financial assistance.
Contacting MHS Indiana Support
If you have questions about your benefits or need help with a claim, MHS offers several ways to get in touch. Their member services department is trained to help you understand the specifics of your plan.
Most plans have a dedicated toll-free number listed on the back of the member ID card. MHS also provides a 24/7 Nurse Advice Line, which allows you to speak with a registered nurse about health concerns at any time of day or night.
For non-urgent questions, the MHS website offers a “Contact Us” form and a comprehensive FAQ section. These resources can often provide the answers you need without having to wait on hold.
Conclusion
MHS Indiana provides essential health insurance coverage to thousands of residents through Medicaid and Marketplace options. By understanding your specific plan, utilizing the My Health Pays rewards program, and staying within the provider network, you can maximize your benefits and maintain your health effectively. Always stay proactive with your preventive care and use the member portal to keep your information up to date.
For more information on navigating healthcare and insurance, feel free to explore our other articles on SearchAndHelp.com. We provide easy-to-understand guides on everything from choosing a primary care doctor to understanding complex medical bills.