When rendering services, Indiana Health Coverage Programs (IHCP) providers must be aware of the IHCP program in which an IHCP member is enrolled. For members enrolled in the Healthy Indiana Plan (HIP), Hoosier Care Connect, Hoosier Healthwise or Indiana PathWays for Aging (PathWays) managed care programs, it is also important to identify the managed care entity (MCE) with which the member is enrolled.
Pharmacy Benefit Management
Select the link associated with the program/health plan with which the member is enrolled to see applicable pharmacy benefit information, such as Preferred Drug Lists (PDLs) and drug prior authorization (PA) criteria.
Fee-for-Service Programs:
Managed Care Programs:
- Anthem – HIP, Hoosier Healthwise, Hoosier Care Connect, PathWays
- CareSource – HIP, Hoosier Healthwise
- Humana – PathWays
- MDwise – HIP, Hoosier Healthwise
- Managed Health Services (MHS) – HIP, Hoosier Healthwise, Hoosier Care Connect
- UnitedHealthcare – Hoosier Care Connect, PathWays
Statewide Program Support
Optum Rx provides support for statewide pharmacy policy development, including pharmacy boards and committees, as well as the management of the drug rebate program. For more information, see the Optum Rx Indiana Medicaid website.
Opioid Therapy Management Resources
The Indiana Family and Social Services Administration (FSSA) is making resources for the management of opioid therapy easily available to the provider community. Select the links below for access to these resources:
- Substance Use Disorder (SUD)/Serious Mental Illness (SMI) Treatment
- Overdose Prevention Therapy-Indiana (optIN)
- NextLevel Recovery
- Indiana State Medical Association's End the Epidemic
- American Hospital Association's Stem the Tide: Addressing the Opioid Epidemic
- Opioid Awareness: Minimizing Risks
- Substance Abuse and Mental Health Services Administration (SAMHSA) Medications for Substance Use Disorders
- CDC Pocket Guide: Tapering Opioids for Chronic Pain
- Sample Provider Opioid Education Letter