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 7-3 - HIP Plus covered benefits and services; noncovered services
Universal Citation: 405 IN Admin Code 7-3
Current through September 18, 2024
Authority: IC 12-15-44.5
Affected: IC 12-15-44.5
Sec. 3.
(a) This section outlines the services available to an individual enrolled in HIP Plus. The covered services provided under HIP Plus are in accordance with the essential health benefit requirements under 42 CFR 440.347 for alternative benefit plans.
(b) HIP Plus 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) Vision services.
(11) Dental services.
(12) Early and periodic screening,
diagnostic, and treatment services for members nineteen (19) and twenty (20)
years of age.
(13) Any other
services approved by the Centers for Medicare and Medicaid Services in the HIP
Plus alternative benefit plan.
(c) The following services shall not be covered under HIP Plus:
(1) Services that are
not medically necessary.
(2)
Nonemergency transportation services.
(3) Any other services not approved by the
Centers for Medicare and Medicaid Services in the HIP Plus alternative benefit
plan.
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