MHS Indiana

What MHS Indiana does

MHS Indiana (Managed Health Services) is an Indianapolis-based health insurance company founded in 1994 and operating as a subsidiary of Centene Corporation (NYSE: CNC). The company administers government-sponsored health insurance programs exclusively for Indiana residents across four product lines: Medicaid managed care through the Healthy Indiana Plan (HIP) for adults 19-64, Hoosier Healthwise for children and pregnant women, and Hoosier Care Connect for seniors and disabled individuals; Medicare Advantage under the Wellcare brand; and ACA Marketplace coverage under the Ambetter Health brand. Revenue is generated primarily through capitated per-member-per-month premiums from the Indiana Family and Social Services Administration (FSSA) and federal Medicare/Marketplace channels.

The underlying technology stack includes a secure member portal for benefits management and health needs screening, a MyMHS mobile application for iOS and Android, a provider directory search tool, and integrated telehealth services via Teladoc Health for 24/7 virtual medical, mental health, and dental consultations. Supporting platforms include Pyx Health for social determinants of health navigation, Community Connect for local resource matching, and a chatbot interface ("Ask MHS") on the public website. The company maintains NCQA accreditation and partners with Teladoc, Mental Health America of Indiana, Indiana Tobacco Quitline, the Indianapolis Public Library, and the Indiana Hospital Association to deliver member services.

MHS Indiana pursues an event-driven go-to-market motion centered on community engagement (over 300 sponsored or attended events annually), provider referrals through a statewide Primary Medical Provider network, and state-agency partnerships with FSSA Division of Family Resources offices. Distribution channels include the state Medicaid enrollment portal (HIP.IN.gov), the federal Health Insurance Marketplace (HealthCare.gov), Medicare.gov, and direct member self-service via portal and mobile app. The company employs 501-1000 staff and is led by Chairman, President and CEO Kevin O'Toole.

Name

MHS Indiana

Legal name

Managed Health Services (MHS Indiana)

Website

https://mhsindiana.com

Company type

Private

Founded year

1994

Operating status

Operating

Headcount range

501–1,000 employees

Short description

MHS Indiana is a Centene Corporation subsidiary providing Medicaid (HIP, Hoosier Healthwise, Hoosier Care Connect), Medicare Advantage (Wellcare), and ACA Marketplace (Ambetter) health insurance exclusively to Indiana residents through capitated government contracts and a statewide provider network.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Behavioral Health Managed Care (Medicaid) / BH Carve-In-Carve-Out Plans (HLAEAEAE)

akta.pro secondary industries

D-SNP Medicare–Medicaid Integration & State Contracting (HLAEAFAH), SNP Model of Care (MOC) & Care Management Programs (HLAEAGAE)

Keywords

• Medicaid managed care
• Medicare Advantage plans
• Health insurance marketplace
• Managed care organization
• Government health programs

Headquarters

HQ city

Indianapolis

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Marketing or Sales, Technology or R&D, Infrastructure

Revenue model

1. Medicaid Premiums: MHS Indiana receives government premiums from the State of Indiana for administering Medicaid programs including HIP, Hoosier Healthwise, and Hoosier Care Connect. These are capitated payments per member per month.
2. Medicare Advantage Premiums: MHS Indiana receives Medicare Advantage premiums through the Wellcare brand for Medicare-eligible members aged 65 and older or those with disabilities.
3. Marketplace/Exchange Premiums: Ambetter Health plan generates premiums from individuals and families purchasing coverage through the Health Insurance Marketplace, with potential premium subsidies based on income and family size.

Pricing tiers

Go-to-market motion1 record

Distribution channels6 records

Marketing channels7 records

Core offering

MHS Indiana is a managed care health insurance plan serving Indiana residents through Medicaid programs (Healthy Indiana Plan/HIP, Hoosier Healthwise, Hoosier Care Connect), Medicare Advantage (Wellcare), and Marketplace (Ambetter Health) products. The plans are complemented by telehealth services via Teladoc, behavioral health programs, pregnancy and newborn support programs, care coordination, rewards incentives, and member self-service through a mobile app and online portal.

Product overview

MHS Indiana operates as a health insurance provider offering multiple coordinated health insurance plans and healthcare management programs for Indiana residents. The portfolio includes Medicaid plans (Healthy Indiana Plan/HIP for adults 19-64, Hoosier Care Connect for seniors/disabled, and Hoosier Healthwise for children/pregnant women), Medicare Advantage (Wellcare), and Marketplace coverage (Ambetter Health). Supporting these plans, MHS provides integrated services including Teladoc telehealth (general care, mental health, dental), behavioral health and substance abuse programs, pregnancy support (Start Smart for Your Baby, Special Deliveries, Doula and Me), children's health education (Healthy Kids Club), reward programs (My Health Pays, POWER Account), transportation assistance, and a mobile app. Members access services through a secure online portal, provider search tool, and 24/7 nurse line. The company is NCQA Accredited and part of Centene Corporation.

Differentiator

Problem solved

Functional benefit

Brands

• Ambetter Health: Health Insurance Marketplace plan offered by MHS Indiana for individuals and families.
• Wellcare
• Healthy Indiana Plan (HIP)
• Hoosier Healthwise
• Hoosier Care Connect
• MyMHS

Products and services

• Healthy Indiana Plan (HIP) Medicaid health insurance program for qualified Indiana adults aged 19-64, covering medical costs and potentially including dental, vision, and chiropractic benefits, with healthy-behavior rewards via the POWER Account.
• Hoosier Care Connect Coordinated Medicaid care program for Indiana members aged 65 and older, or with blindness or disability, who reside in the community and are not eligible for Medicare, providing all Medicaid-covered benefits plus care coordination services.
• Hoosier Healthwise Medicaid health coverage program for children up to age 19 and pregnant women in Indiana, with eligibility based on family income, covering preventive care, immunizations, EPSDT services, and pregnancy care.
• Ambetter Health Health Insurance Marketplace plan offering affordable health care coverage for Indiana individuals and families, with potential premium assistance based on family size and income.
• Wellcare Medicare Advantage Medicare Advantage plan providing coverage for Medicare-eligible Indiana residents aged 65 and older or with disabilities, with access to a doctor network, case managers, a 24-hour nurse line, and member service representatives.
• Teladoc Virtual Care 24/7 virtual care service via phone or video with board-certified health professionals for non-urgent conditions, including mental health therapy and psychiatry, and dental consultations for MHS Indiana members.
• Find a Provider Tool Online search tool enabling Indiana residents to find Primary Medical Providers, hospitals, pharmacies, and other healthcare facilities within the MHS Indiana network.

Named customers5 records

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

Feature4 records

Partnerships

Six partnerships are on record, tiered core and minor.

• Mental Health America of IndianacoreStrategic or Co-development PartnerMHS partners with Mental Health America of Indiana for the Member Ombudsman Program. The ombudsman provides neutral assistance to help members resolve problems with MHS, services, doctors, or other aspects of their healthcare. This is a free service available 7 a.m. to 7 p.m. Monday through Friday.
• Indiana Tobacco QuitlinecoreStrategic or Co-development PartnerMHS partners with the Indiana Tobacco Quitline to help members quit smoking. Members can earn $100 in My Health Pays rewards for completing the Indiana Quitline program by calling 1-800-QUIT-NOW.
• Teladoc HealthcoreTechnology or IntegrationTeladoc Health provides 24/7 virtual care services for MHS members including non-urgent medical conditions, mental health services (therapy and psychiatry), and dental consultations via phone or video.
• Indianapolis Public LibraryminorStrategic or Co-development PartnerMHS partners with Indianapolis Public Library for community events including baby showers hosted at library branches like the Spades Park Branch location.
• Pyx HealthminorStrategic or Co-development PartnerPyx Health provides assistance to MHS members in finding doctors, food, transportation, and offers chat functionality with Pyx Health staff.
• Indiana Family and Social Services Administration (FSSA)coreStrategic or Co-development PartnerMHS Indiana works with the Indiana FSSA to administer state Medicaid programs including HIP, Hoosier Healthwise, and Hoosier Care Connect.

Scale indicators2 records

Recent moves2 records

Expansion highlights4 records

Emerging players

• Oscar Health: Technology-led Marketplace-focused insurer competing against MHS Indiana's Ambetter plan. Smaller scale but increasingly visible in individual ACA markets including Indiana.

Direct peers

• Molina Healthcare: State-focused Medicaid and government-sponsored managed care company with similar business model to MHS Indiana's parent Centene, operating in multiple states. Comparable mix of Medicaid, MA D-SNP, and Marketplace products.
• Anthem Blue Cross and Blue Shield of Indiana: Operates as a major Indiana Medicaid managed care plan alongside MHS Indiana under the Hoosier Healthwise, HIP, and Hoosier Care Connect programs, and also offers Medicare Advantage and Marketplace products in the same state. Directly comparable product portfolio and customer base in Indiana.
• UnitedHealthcare of Indiana: National managed care leader with Indiana Medicaid, Medicare Advantage, and Marketplace offerings competing head-to-head with MHS Indiana across all three product lines.
• CareSource Indiana: Nonprofit Medicaid managed care plan operating in Indiana, competing directly with MHS Indiana for Hoosier Healthwise, HIP, and Hoosier Care Connect members.

Broad incumbents

• Aetna (CVS Health): National health insurer offering Medicaid, Medicare Advantage, and Marketplace products. Competes with MHS Indiana across multiple product lines and benefits from CVS Health's care delivery integration.
• Humana: One of the largest Medicare Advantage insurers in the country and a direct competitor to MHS Indiana's Wellcare MA line. Humana also has growing Medicaid presence, making it a broad incumbent in government-sponsored coverage.
• Kaiser Permanente: Integrated managed care organization combining insurance and care delivery. Operates Medicare Advantage and commercial plans; structurally different but a relevant managed care peer for value-based care comparison.
• Amerigroup (Elevance Health): Medicaid-focused subsidiary of Elevance Health operating across multiple states with the same government-sponsored managed care model as MHS Indiana. Closest analog to a Centene-style state plan subsidiary.
• Cigna Group: Large diversified health insurer with Medicare Advantage and Marketplace presence that competes with MHS Indiana's Wellcare and Ambetter lines.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• YouTubeyoutube.com/user/MHSIndiana
• Facebookfacebook.com/ManagedHealthServices
• LinkedInlinkedin.com/company/managed-health-services/mycompany

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments19 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about MHS Indiana