The Indiana Insurance Exchange (Marketplace) is the Federally-Facilitated Marketplace.
The Federally-facilitated Marketplace is administered by the federal government, under the Department of Health and Human Services (HHS).
General information about the Federally-facilitated Marketplace can be found at: https://www.healthcare.gov/marketplace/individual/#state=indiana.
PATIENTS
The Federally-facilitated Marketplace is essentially a marketplace for individuals to shop for health insurance if they do not already have insurance coverage from another source. If individuals have insurance from another source such as employment, retirement benefits, or spousal benefits, they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the Federally-facilitated Marketplace.
This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.
As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
In pursuing participation in Qualified Health Plans, providers should notify the plans that they meet the criteria as an ECP.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
Indiana Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, IN 46204
317-232-2385
www.in.gov/idoi/
Complaints: www.in.gov/idoi/2552.htm
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Federally-facilitated Marketplace.
Illinois has established Blue Cross Blue Shield of IL as the “benchmark” plan.
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.
Ambetter from MHS
Plan Website: http://www.mhsindiana.com/for-members/your-benefits/
Provider Enrollment: http://www.mhsindiana.com/for-providers/become-a-provider/
Plan types offered: Individual
Anthem Blue Cross and Blue Shield
Plan Website: https://www.anthem.com/health-insurance/Indiana/health-plans/
Provider Enrollment: http://www.anthem.com/wps/portal/ahpprovider?content_path=provider/co/f5/s2/t0/pw_000621.htm&state=co&label=Join Our Networks
Plan types offered: Individual, SHOP
Assurant Health
Plan Website: http://www.assuranthealth.com/corp/ah/AHHome.htm
Provider Enrollment: http://www.assuranthealth.com/corp/ah/Providers/health-care-provider.htm
Plan types offered: Individual
CareSource Just4Me
Plan Website: https://www.caresource.com/providers/indiana/just4me/
Provider Enrollment: https://www.caresource.com/members/indiana/
Plan types offered: Individual
IU Health Plans
Plan Website: http://www.myiuhealthplans.com/
Provider Enrollment: http://www.kaiserpermanentejobs.org/default.aspx
Plan types offered: Individual
MDwise Marketplace
Plan Website: http://www.mdwise.org/for-members/healthy-indiana-plan/
Provider Enrollment: http://www.mdwise.org/for-providers/contact-information/
Plan types offered: Individual
PHP (Physicians Health Plan)
Plan Website: http://www.phpmichigan.com/
Provider Enrollment: http://www.phpmichigan.com/Providers/General-Forms-and-Information/Credentialing
Plan types offered: Individual, SHOP
SIHO Insurance Services
Plan Website: http://siho.org/
Provider Enrollment: http://siho.org/ProviderDirectory/
Plan types offered: Individual
UnitedHealthcare
Plan Website: http://www.uhc.com/health_reform_guide.htm
Provider Enrollment: http://www.uhc.com/physicians/join_our_network.htm
Plan types offered: Individual