1. HIP Enhanced Service Plan (ESP) Overview

2. The HIP Enhanced Services Plan (ESP) is designated for certain individuals with health care conditions that require additional support. These conditions include: Internal Cancers HIV/AIDS Hemophilia Aplastic Anemia Organ Transplants What is HIP ESP?

3. How is a person enrolled in HIP ESP? The application for HIP does NOT allow a member to select HIP ESP as their plan. Plan selections include Anthem and MDwise. Medical questions and consent for medical records is used to determine if a person qualifies for HIP ESP. If an applicant answers ‘yes’ to any medical questions, they are reviewed for possible inclusion in the ESP plan. Medical record review determines if a member remains in ESP or is sent to their original plan choice.

4. What is Covered? The benefits under the HIP-ESP Plan are identical to benefits offered by the other HIP insurers: Lifetime Maximum - $1M Benefit Year Maximum - $300,000 Health benefits include hospital services, mental health care, doctor visits, prescriptions, diagnostic exams and disease management. HIP ESP does not cover pregnancy, vision or dental The POWER Account for HIP ESP participants is handled differently than commercial carriers. HIP ESP members may be treated by any provider enrolled with EDS in the Indiana Health Coverage Programs (IHCP).

5. How Much Does it Cost? Members must pay a small monthly Contribution The exact cost of the Contribution depends on income and family size. Monthly Contributions may be reduced by other medical payments made within a household, including premiums made to the Hoosier Healthwise program. An individual’s employer may contribute up to 50% of the individual’s required contribution for the program.

6. How Much Does it Cost? Example Contribution Illustration Single Adult, No Children Monthly IncomePercent Contribution Estimated Monthly Contribution $0 - $8502%$17 $851 – $10633%$32 $1064 - $12764%$51 $1277 - $14895%$74

7. The State has contracted with the Indiana Comprehensive Health Insurance Association (ICHIA). ICHIA also operates the State’s high-risk pool. ICHIA contracts with ACS to handle member services and claims, and APS for disease management services and utilization management. ACS and APS have experience providing health care to persons with significant and serious health conditions. EDS processes pharmacy claims. Who is Managing HIP ESP?