You Can Change Your Indiana Medicaid Health Plan: What Parents Need to Know
Many Indiana families don’t realize they have a choice when it comes to their Medicaid health plan. If your current plan isn’t meeting your family’s needs, you may be able to switch to a different health plan.
The process can seem confusing, but understanding your options can help you make the best decision for your child and your family.
What Is a Medicaid Health Plan?
Indiana Medicaid contracts with private health insurance companies to provide healthcare services. These companies are often referred to as Managed Care Organizations (MCOs) or Managed Care Entities (MCEs). Both terms refer to your Medicaid health plan.
Current Indiana Medicaid health plans include:
- Anthem
- CareSource
- Managed Health Services (MHS)
- UnitedHealthcare Community Plan
Your Medicaid Program Determines Your Health Plan Options
Not every Indiana Medicaid member has the same health plan choices. The plans available to you depend on the Medicaid program you’re enrolled in.
For example:
- Hoosier Healthwise (HHW) members can currently choose from Anthem, CareSource, or Managed Health Services (MHS).
- Hoosier Care Connect (HCC) members can currently choose from Anthem, Managed Health Services (MHS), or UnitedHealthcare Community Plan.
Before requesting a health plan change, verify which Medicaid program you’re enrolled in and which health plans are available to you.
Can You Change Your Medicaid Health Plan?
Yes.
Indiana Medicaid members may be be able to change their health plan during certain enrollment periods or if they qualify for a special reason to change plans.
You may be able to switch if:
- You are within your initial enrollment period.
- You qualify for a “just cause” change.
- Your annual open enrollment period is available.
- Indiana Medicaid approves your request.
What Is “Just Cause”?
Indiana Medicaid allows members to request a health plan change for specific reasons.
Examples may include:
- Your doctors or therapy providers are not in your current plan’s network.
- You have difficulty accessing medically necessary healthcare services.
- You have continuity-of-care concerns.
- Your child needs specialists who participate with a different health plan.
- Your family has moved or your healthcare needs have changed.
- Your provider leaves your health plan’s network.
Each request is reviewed individually, and approval is not automatic.
Before You Request a Change
Before requesting a new Medicaid health plan, take a few minutes to review the following:
✔ Are all of your child’s providers—including ABA, speech therapy, occupational therapy (OT), physical therapy (PT), physicians, and specialists—in the new health plan’s network?
✔ Does the new plan cover services where your child receives care, including home, clinic, or school?
✔ Will changing health plans require new referrals or prior authorizations?
✔ Are your preferred providers accepting new patients?
Taking a few minutes to verify these details before switching can help prevent delays or interruptions in your child’s care.
How to Request a Health Plan Change
Indiana Medicaid Enrollment Broker
Before you call, have your Medicaid member ID card available.
- Hoosier Healthwise (HHW): 1-800-889-9949
- Hoosier Care Connect (HCC): 1-866-963-7383
The enrollment broker can explain your available health plan options and help you complete a health plan change if you’re eligible.
You can also visit the Indiana Medicaid member website for:
- Health plan comparisons
- Provider directories
- Enrollment information
- Member resources
https://www.in.gov/medicaid/members
If your child receives ongoing therapy services, talk with your providers before changing health plans. A new health plan may require new prior authorizations, and planning ahead can help prevent interruptions in services.
Need Help Deciding?
If you’re unsure whether changing health plans is the right decision, consider speaking with:
- Your child’s healthcare providers
- Your ABA provider’s billing or care coordination team
- Indiana Medicaid Member Services
- The Indiana Medicaid enrollment broker
They can help you understand your options and determine whether another health plan may better meet your family’s needs.
Final Thoughts
Every family’s healthcare needs are different. Before changing your Indiana Medicaid health plan, compare provider networks, verify your child’s providers participate with the new plan, and understand how a change could affect ongoing services.
With a little planning, you can make an informed decision and help ensure your child continues receiving the care they need.
Disclaimer: Indiana Medicaid policies, participating health plans, provider networks, and enrollment rules may change. Always verify current information with Indiana Medicaid and your chosen health plan before making enrollment decisions.
