Indiana’s version of Medicaid, the Healthy Indiana Plan, offers much more than just access to lower-cost health insurance. It also can provide help in finding a job, housing, and transportation as well as a free cellphone and access to educational services.
When Leona Cullen moved to Noblesville from Hawaii in December, she knew she would need health insurance in her new home. She also knew she would need a job. What she didn’t know was that an Indiana Medicaid provider could help her achieve both those goals.
One month away from giving birth, Cullen, 42, visited a hospital emergency room in January, where staff helped her sign up for CareSource’s Healthy Indiana Plan. Not only did the plan cover the medical expenses associated with the birth of her daughter at the end of January, it also connected Cullen with Jessica Rockhill, a life coach who helped her organize her life.
Rockhill advises Cullen on filling out job applications and dressing appropriately for interviews. She suggested ways for Cullen to improve her employment prospects.
Cullen never expected such aid to come from her health insurer.
“I just thought medical was just medical that just paid our bills,” she said. “I didn’t know that they had people that would support us in life skills and job opportunities and resources for different things, like housing. That amazed me.”
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The state of Indiana, which contracts with four insurers to provide the Healthy Indiana Plan, does not mandate that the insurers provide any specific enhanced benefits for its members. However, the contracts do encourage the providers to include value-added programs, said Indiana Medicaid director Joe Moser.
Such programs can include life coaching, assistance with earning high school diplomas or other degrees, free cellphones, transportation and rewards programs to encourage healthy behavior.
Helping people address other obstacles in their lives, the thinking goes, will eventually lead them to focus on their health.
“There are a lot of things that the health plans have discovered that it makes sense to provide for them, things that improve the health and well-being of the individual served. … By virtue of their Medicaid eligibility, they have other needs in their life that commercially insured individuals may not have,” Moser said.
Private health insurance rarely offers such benefits. But the low-income population that qualifies for Medicaid has different needs than those who receive health insurance through their job or are able to purchase it themselves, Moser said.
To be eligible for the Healthy Indiana Plan, Indiana’s version of Medicaid expansion, a person must be at 133 percent or less of the federal poverty level. For a family of four, that would translate into a monthly income of $2,863 or less. The plan requires people at the upper limits of HIP eligibility to pay monthly contributions to so-called POWER accounts to maintain their coverage.
“Not only are you expecting members to be engaged more in their health care through the POWER account, you’re expecting members to be more sophisticated in how they interact with healthcare,” said John Barth, chief operating officer of MHS Indiana, a HIP insurer. “What you see in the different health plans, we’re all putting our own spin on what they will need.”
One of the most popular benefits that most of the state’s four HIP providers offer are free cellphones that come with a few hundred minutes a month and unlimited texting to ensure case managers and providers can contact members.
Anthem Indiana Medicaid case managers, for instance, know to reach out to their members within the first few days of the month, when the cellphones are sure to be active, said Katie Zito, senior director of government relations for Anthem Indiana Medicaid.
“To help with cellphones is a no-brainer for us because we’re able to keep in contact with a member,” Zito said.
Unlimited texting can be key to staying in touch. Plans can use it to send regular text messages to encourage healthy behaviors or guide a member through smoking cessation.
MHS Indiana recently started a crisis text line that provides anonymous counseling. The crisis line will allow members to reach out in an emergency and the counselor will then steer them via text to in-person services near them. Not only does texting provide a way for people in isolated rural areas to get immediate help, some people just feel more comfortable with texting.
Many of the insurers, as well as the state, offer assistance with finding employment.
All Healthy Indiana Plan members who are unemployed or working less than 20 hours a week can enroll in the state’s Gateway to Work program. It debuted in 2015 and offers coaching on job skills such as resume building and can lead to additional training and education.
Anthem Indiana Medicaid places a premium on helping people find employment, as well, and will cover the cost of taking the high school equivalency exam for those who lack a diploma.
“Individuals who are working are more socially connected and when you’re more socially connected, you feel happier and healthier,” Zito said.
CareSource Indiana’s LifeServices program can assist with everything from food to housing and child care, all in the interest of helping members find long-term employment and through that better health.
If a member is identified as being eligible for the program, he or she is connected with a life coach who helps them navigate the world of job searching in monthly meetings. About 15 employers across the state, such as FedEx, Kroger and Lowe’s, partner with CareSource on finding appropriate openings for these individuals. Even if members find full-time employment and get off of Medicaid, the coach works with them for two years.
While this may seem like a poor business plan for the insurers, they say it’s worth it.
“Ultimately our goal is to get people off of Medicaid into employer-sponsored insurance,” said Steve Smitherman, executive director of CareSource Indiana.
Indiana’s program launched earlier this year. In Ohio, where CareSource has offered this program for the past two years, about 425 people have found employment through the program. Of those, about 70 percent are now off Medicaid, Smitherman said. In addition, those in this program use the emergency room less and have increased the preventive services they access.
The program can also help members secure affordable, safe housing and, if they need, even set them up with temporary housing.
In an effort to encourage members to be proactive about their health, MHS Indiana and MDWise offer members rewards programs for engaging in recommended screenings, tobacco cessation and other healthy choices. MDwise members can use theirs at a number of businesses, including iTunes, Subway, AMC, some grocery stores, Walgreens, Target, Speedway, Kohl’s and Toys/Babies R Us.
MHS Indiana members can redeem their CentAccount dollars at Family Dollar, Meijer, Dollar General, Rite Aid or Wal-Mart. Recently, MHS Indiana added another way to spend CentAccount dollars: to pay the monthly POWER Account contribution.
For Cullen, CareSource’s LifeServices program is a health benefit that has touched just about every aspect of her life. Her life coach, Rockhill, has helped her find multiple jobs. She has a fast-food job and recently got a second job at IndyGo, and Rockhill continues to help.
“Every job that I have, Jessie has been a part of,” she said. “She’s a big blessing to me really. … I’ve never had a person like this to help me.”