Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 10 - HEALTHY INDIANA PLAN
Rule 7 - Benefits and Medical Policy
Section 7-2 - HIP Basic covered benefits and services; noncovered services
Universal Citation: 405 IN Admin Code 7-2
Current through September 18, 2024
Authority: IC 12-15-44.5
Affected: IC 12-15-44.5
Sec. 2.
(a) This section outlines the services available to an individual enrolled in HIP Basic. The covered services provided under HIP Basic are in accordance with the essential health benefit requirements under 42 CFR 440.347 for alternative benefit plans.
(b) HIP Basic shall include covered services in each of the following categories:
(1) Ambulatory patient services.
(2) Emergency services.
(3) Hospitalization.
(4) Maternity services.
(5) Mental health and substance abuse
services.
(6) Prescription
drugs.
(7) Rehabilitative and
habilitative services and devices.
(8) Laboratory services.
(9) Preventive care services.
(10) Early and periodic screening,
diagnostic, and treatment services for members nineteen (19) and twenty (20)
years of age.
(11) Any other
services approved by the Centers for Medicare and Medicaid Services in the HIP
Basic alternative benefit plan.
(c) The following services shall not be covered under HIP Basic:
(1) Services that
are not medically necessary.
(2)
Dental services.
(3) Vision
services.
(4) Nonemergency
transportation services.
(5) Any
other services not approved by the Centers for Medicare and Medicaid Services
in the HIP Basic alternative benefit plan.
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