Hoosiers Get Extra Time to Choose New Medicaid Plans

The state has given Hoosiers extra time to select new Medicaid plans. This is especially true if you’re a part of the Healthy Indiana Plan or PathWays program and are affected by the loss of MDwise managed care options. The state has extended the deadline for open enrollment to December 24, 2020. This gives you more time to compare plans, and to decide which plan is best for your budget and health.

You will still have Medicaid coverage if you do nothing. However, the state will choose a plan that may not suit your doctors or medications. If this is the case, you may be required to change it later. This short extension is important because it gives you the chance to make your own decisions instead of being assigned a plan.

Hoosiers Get Extra Time to Choose New Medicaid Plans

Indiana’s Family and Social Services Administration has extended the open enrollment period for HIP and PathWays health plans until December 24, 2025 because so many members have contacted them and are reviewing their options. You can compare the benefits of different plans, see which ones cover your doctors and make a decision that is right for you.

MDwise will also stop offering Medicaid managed care plans after January 1, 2026. If you are currently enrolled in MDwise, then you must switch to another plan, such as Anthem CareSource or MHS. State officials stress that Medicaid eligibility and core health benefits will remain the same, but you must choose a different plan in order to avoid any surprises after January 1, 2026.

Hoosiers New Medicaid Plans Time Line

Topic	What you should know
New enrollment deadline	Choose your health plan by December 24, 2025.
Who is most affected?	Those who are currently enrolled in MDwise, the Healthy Indiana Plan or Hoosier healthwise managed care programs.
MDwise ending	After January 1, 2026 MDwise will cease to be a Medicaid managed health care plan. You must then move over to Anthem CareSource or MHS.
You can’t do anything	The state will assign you a plan that closely matches the coverage of your existing policy.
Changes within 90 days	You have 90 days to change plans if you do not like the new plan after you enroll.
Coverage protection	The MDwise switch does not affect your Medicaid coverage. Prior authorizations and treatments are still valid during the transition period.
Official Website	https://www.in.gov/

What it means to you as a Member

You will usually stay with the same health plan for an entire year, unless there is a “justifiable” reason to switch. The annual lock-in makes the open enrollment period and the additional time that you have just received so crucial for your long-term health care.

Use this time to compare plans that include your doctors, hospitals and pharmacies. Also, check how they handle prescriptions, transportation and other benefits. While many plans provide similar Medicaid coverage, small differences in network and support services could make or break your experience over the coming year.

Automatic Assignment: How it works

FSSA will enroll you automatically in the plan that it believes best matches your current coverage if you don’t choose a new one by December 24, 2025. It is intended to cover gaps in coverage but may not meet all of your needs. For example, it may not allow you to keep a particular primary care provider or a specialist.

Members who leave MDwise have an added protection. You can change your managed care plan within 90 days of the start date of your new plan, if you’re not happy. Your new plan must honor any existing authorizations or ongoing treatments during the transition period to ensure that you do not lose access to approved care.

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What You Can Do

Start by gathering all your important information, including a list your doctors, pharmacies, scheduled procedures and prescriptions. Then, compare the provider directory of each plan and its drug list to your list. You should pay special attention to your primary doctor and nearest hospital, as using providers outside of the network can cause billing issues.

If you need assistance comparing options or making the switch to Medicaid from MDwise, call the enrollment helpline or visit Indiana’s official Medicaid Member Resources page. You can choose your plan before December 24 so that your coverage will begin smoothly on January 1.

The open enrollment period for Indiana Medicaid will now run through December 24, 2020. This is a second chance for you to make an informed decision. You can reduce your stress in 2026 by using the extra time to examine your options, confirm doctors and select a plan which fits your lifestyle.

FAQ’s

1. If you miss the December 24, deadline will you lose Medicaid?

No. If you miss the deadline for Medicaid coverage and eligibility, your coverage may end. However, you could be automatically assigned to a plan that you didn’t choose.

2. What if I am already a MDwise customer?

After January 1, 2026, MDwise will no longer participate in Indiana Medicaid managed services. You will be assigned to a managed care plan if you don’t choose one. Then you have 90 days in which you can change it if necessary.

3. You can change your plans if you’re unhappy.

You have 90 days to switch plans if you’re transitioning from MDwise. You will need to wait until next open enrollment period if you are outside of this time frame, unless there is a “just cause”.