Premiums and Copays
Hoosier Healthwise Copayments
Hoosier Healthwise members do not have copayments.
CHIP Copayments
CHIP members may have copayments for some services:
| Service | Copayment |
|---|---|
| Prescription Drugs - Generic, Compound and Sole-Source | $3 |
| Prescription Drugs - Brand Name | $10 |
| Emergency Ambulance Transportation | $10 |
Any medication dispensed as an Emergency Supply will not have a copay.
CHIP Premiums
There is a small monthly premium payment for all CHIP members. The amount you are required to pay is based on your family income and number of children on the CHIP program in your family:
| Income (As a percent of FPL) | One Child | Two or More Children |
|---|---|---|
| Over 158 to 175 percent | $22.00 | $33.00 |
| Over 175 to 200 percent | $33.00 | $50.00 |
| Over 200 to 225 percent | $42.00 | $53.00 |
| Over 225 to 250 percent | $53.00 | $70.00 |
CHIP Late Payments and Disenrollment
Monthly premiums are due by the due date listed on your monthly invoice from the State. After that due date, you have 60 days to make your payment before you lose CHIP coverage.
If you have been disenrolled due to non-payment of premiums, you can reapply. But, you will not be eligible until all past due premiums and the premium for the current month is paid to the State. A payment of less than the full amount due will not be accepted and will be considered nonpayment.
You will not be charged for the time between the date of disenrollment and the date that coverage resumes. However, any services received during that time period will not be retroactively covered.