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Indiana Medicaid


Indiana Medicaid offers health insurance to low-income families, children, and pregnant women, as well as disabled, blind, and aged individuals. Through various programs specific to each group, Medicaid delivers coverage on all necessary medical services whether you are healthy or have a condition in need of treatment. Offering coverage for free or a small monthly fee, each program operates differently, while providing each member with coverage they can manage to pay for.

Administered by managed care organizations throughout the state, you can receive a more simplified approach to seeking quality healthcare. With a designated primary care doctor to guide you through the process, you can rely on a familiar source who knows your health needs. In addition to the standard programs, Indiana Medicaid offers waiver services to residents of any age who have special health needs and prefer to live at home rather than in an institution.

Indiana Medicaid programs include:

  • Hoosier Healthwise: pregnant women, children, and families
  • Care Select: individuals with special health needs (may be aged, blind, disabled, foster children, wards of the court, children receiving adoptive services)
  • Healthy Indiana Plan (HIP): low-income adults, both parents and childless
  • Traditional Medicaid: dual eligible Medicaid/Medicare beneficiaries, those with a spend down/monthly deductible, and refugees
  • M.E.D. Works: employees with disabilities
  • Waiver: low-income individuals with special medical needs

 

Indiana Medicaid Eligibility

Medicaid eligibility is determined by various factors, based on the category you fit into, family size, and income. All qualifying applicants must be residents of Indiana, and a U.S. citizen or legal immigrant. Your income is evaluated based on your family size, and includes earned wages and Social Security Disability payments. Resources and assets may also be considered for those who qualify for certain programs, including aged, blind, and disabled individuals. According to each eligibility group’s earnings in relation to the Federal Poverty Level, an income limit is established.

 

Current Federal Poverty Guideline

 

Pregnant Women 200%

Family of 2: $2,522 monthly, $30,260 yearly

Family of 3: $3,182 monthly, $38,180 yearly

Family of 4: $3,842 monthly, $46,100 yearly

Family of 5: $4,501 monthly, $54,020 yearly

*$1,000 asset limit

 

Children Up to Age 19 150%

Family of 1: $1,397 monthly, $16,764 yearly

Family of 2: $1,892 monthly, $22,704 yearly

Family of 3: $2,387 monthly, $28,644 yearly

Family of 4: $2,882 monthly, $34,584 yearly

 

Parent (unemployed) 19%

Family of 1: $177 monthly, $2,122 yearly

Family of 2: $240 monthly, $2,874 yearly

Family of 3: $302 monthly, $3,627 yearly

Family of 4: $365 monthly, $4,380 yearly

*$1,000 asset limit

 

Parents (employed) 24%

Family of 1: $223 monthly, $2,680 yearly

Family of 2: $303 monthly, $3,631 yearly

Family of 3: $382 monthly, $4,582 yearly

Family of 4: $461 monthly, $5,532 yearly

*$1,000 asset limit

 

Single Aged, Blind, or Disabled 75%

$698 monthly, $8,377 yearly

 

Couple Aged, Blind, or Disabled 83%

$1,046 monthly, $12,558 yearly

 

Qualified Medicare Beneficiaries (QMB) 100%

Medicaid covers your premiums, coinsurance, and deductibles.

Single: $938 monthly, $11,170 yearly

Couple: $1,260 monthly, $15,130 yearly

 

Specified Low-Income Medicare Beneficiaries (SLMB) 120%

Medicaid covers your premiums only.

Single: $1,117 monthly, $13,404 yearly

Couple: $1,513 monthly, $18,156 yearly

 

Complex Medical Conditions 300% of SSI benefit

Nursing Facility Level of Care Waivers

$2,094 monthly, 425,128 yearly

 

 

Covered Benefits

Benefits vary based on the Indiana Medicaid program in which you enroll. For pregnant women, Hoosier Healthwise covers maternity care only, or full health benefits, depending on your income. For those with special health needs, condition-specific medical services will be included to help serve you better. Many general health care benefits are offered across all programs, when applicable, including:

  • Preventive care
  • Hospital care
  • Physician services
  • Emergency care
  • Clinic services
  • Prescription drugs
  • Over-the-counter medications
  • Laboratory and X-ray services
  • Mental and behavioral health care
  • Substance abuse services
  • Dental care
  • Vision care
  • Nursing facility services
  • Hospice care
  • Family planning
  • Podiatry
  • Medical transportation
  • Occupational, speech, and physical therapies
  • Chiropractic care
  • Medical supplies
  • Durable Medical Equipment
  • Prenatal care and delivery

 

How to Apply

If you identify with the eligibility criteria listed above, and think you qualify for Medicaid, there are several ways to apply. Applications can be completed and submitted online, over the phone, or at a Division of Family Resources (DFR) office near you. To locate a DFR office, visit their website at ww.in.gov/fssa/dfr/2999.htm, scroll down to the map, and select your county of residence.

When applying for Medicaid, make sure you have the following information available for each member of your household:

  • Names and dates of birth
  • Social Security Number
  • Income from jobs or training
  • Currently received benefits including Social Security, Supplemental Security Income (SSI), child support, or veteran’s benefits
  • Amount of money in your checking account, savings accounts or other resources belonging to you
  • Payments for adult or child care Health coverage and/or medical benefits you have presently
  • Monthly rent, mortgage payment, and utility bills
  • Visit the Family and Social Services Administration for county-specific application instructions

 

Apply for Indiana Medicaid Online

Apply for Indiana Medicaid by Phone: 800-403-0864

 

Resources

 

Indiana Medicaid

 

Hoosier Healthwise

800-889-9949

hoosierhealthwise@maximus.com

 

Traditional Medicaid

317-713-9627 or 800-457-4584

 

HIP

877-438-4479

 

Managed Health Services (MHS)

877-647-4848

 

Care Select

866-963-7383

indianacareselect@maximus.com

 

M.E.D. Works

866-273-5897

 

 

Sources:

 

1. Kaiser State Health Facts “Indiana – Medicaid & CHIP”. http://www.statehealthfacts.org/profileind.jsp?cat=4&rgn=16.

2. Indiana Medicaid. “Am I Eligible?” http://member.indianamedicaid.com/am-i-eligible.aspx.

 

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