Indiana Medicaid Application Information

Indiana Medicaid

Indiana Medicaid is a set of different insurance programs that cover eligible Indiana residents and qualified aliens. Applicants falling within a specific Medicaid program will have to meet its criteria in order to receive medical insurance through Indiana Medicaid program.

The Indiana Medicaid program includes Traditional Medicaid, Hoosier Healthwise, Medicaid Waivers, Healthy Indiana Plan (HIP), MED works, Care Select, and Presumptive Eligibility programs. Individuals living in Indiana and seeking medical insurance through Medicaid will have to meet eligibility criteria according to the program category they fall in.

Indiana Health Coverage Program Program website provides complete details about each of these programs. It is easy to apply for each program since it only takes a minute to start your application through online processing. You can apply for health coverage at this link, and for HIP at this link.

Traditional Medicaid

Traditional Medicaid provides health care for families and individuals with low-income. Medicaid is a comprehensive program and covers almost all departments of general health care including doctor visits, prescription drugs, vision and dental care, surgery, hospitalization, mental health, and family planning.

Individuals applying for Traditional Medicaid can get full, limited or only emergency coverage under Medicaid program. Depending on the eligibility criteria you meet, you will be placed in a specific category and your health cover will be determined according to that.

Traditional Medicaid covers the following:

  • Residents of state of Indiana
  • Blind
  • Aged
  • Physically Disabled
  • Mentally Disabled
  • Enrollees of the waiver program
  • Enrollees of Medicare and Medicaid
  • Individuals in state-funded and operated mental facility
  • Individuals enrolled in the Hospice program
  • Aliens

Hoosier Healthwise (HHW)

Hoosier Healthwise is Indiana's prime healthcare program for low-income families, children, and pregnant women. The program provides cover for children up to age of 19 whereas pregnant woman don't have any age limit to qualify for benefits under this program.

The HHW program covers various aspects of medical insurance such as doctor visits, dental care, mental health care, vision care, hospitalization, prescription medicines as well as surgeries. The program also covers family planning after child birth for pregnant women.

Hoosier Healthwise program covers the following categories of Indiana residents:

  • Children under the age of 19
  • Parents and guardians of children under the age of 18 and on low-income
  • Pregnant women

Hoosier Healthwise (HHW) Benefits

Hoosier Healthwise provides various benefits for qualified individuals through different packages.

Package A: This is standard plan and provides full-coverage plan for families, children, and pregnant women. Although enrollees don't have to pay any premium if they qualify for Package A, they may have to co-pay pharmacy and transportation costs. Usually, enrollees will have to pay $0.50 to $3 for co-pay.

Package B: Package B covers pregnant women. Just like Package A, enrollees of package B will have to co-pay up to $.50 to $3 for pharmacy, transportation and emergency costs. Rest of the pregnancy related services such as pre-natal and post-natal care come at no cost at all, in most cases.

Package C: Package C is for children. This program is also called Children's Health Insurance Program (CHIP). We will discuss details later but for now, you just need to know that enrollees will just have to pay a small monthly premium and share co-pay for certain services. The amount of co-pay depends on family income.

Package E: Package E covers emergency services. Serious medical emergencies are covered under Package E. This plan also covers some classes of immigrants who fail to qualify for medical insurance under the other medical packages.

Hoosier Healthwise program also provides benefits that will not require doctor's OK. These benefits are also known as self-referrals services. These include dental care, vision related services, mental health care, podiatrist care, chiropractic care, substance abuse, and transportation services.

Hoosier Healthwise provides preventive care so that most enrollees stay away from disease by taking the preventive care instead of acting after the sickness. Once an individual qualifies for Hoosier Healthwise program, it is important that an appointment with PMP is arranged to ensure medical checkup of the entire family. This will ensure that any problem are possibly cured at time. You will know about your family's needs in time and you will be able to keep your family safe and healthy. Doctor will check for your possible signs of health problems.

Hoosier Healthwise also provides parental care so that pregnant women can take care when they are expecting. Whether its first pregnancy or not, parental care is important and this is what Hoosier Healthwise provides for eligible individuals.

Medicaid Waivers

Medicaid was traditionally paying for long term care services only for those institutionalized. This meant that only the individuals admitted to the institution were to get paid for such services. With Medicaid Waiver, this is not the case anymore. Now, individuals can have Medicaid coverage for long-term care services through Home and Community-Based Services without an admission to any institution.

State of Indiana offers five different programs to cover specific groups with need for long-term care services. These waiver programs are:

  • Aged and Disabled
  • Traumatic Brain Injury
  • Autism
  • Support Services
  • Development Disabilities

Healthy Indiana Plan (HIP)

Healthy Indiana Plan (HIP) provides health cover to those individuals who do not live with a dependent child. The program also provides health benefits for parents who are making less than annual limit according to their family size. Such individuals should be uninsured for a period extending to six months and they should not have an alternative insurance plan through their employer.

HIP may require a small monthly premium but it is not always the case. In fact, it depends on individuals earned income.

HIP doesn't cover vision, dental or maternity services. It does cover the following:

  • Individuals without health insurance for last six months
  • Individuals not having access to insurance cover through their employer
  • Individuals not eligible for Medicaid or Medicare
  • Aged between 19 and 64
  • Legal U.S citizens
  • Residents of state of Indiana
  • Household income

It should be noted that if one qualifies for TANF, he or she is also eligible for medical care and SNAP services.

M.E.D. Works

State of Indiana created a health care program for employees with disabilities. This Medicaid program (known as M.E.D. works) provides a comprehensive health cover for the employees with disabilities and residents of Indiana.

The M.E.D. Works program ensures that people with disabilities don't have to worry about losing their Medicaid cover just because they started working, have raised their income, or simply because they are now working more hours than before. M.E.D. Works takes care of all such cases and ensures that such disabled employees continue receiving benefits under Medicaid.

With medical cover available to employees with disabilities, they can now save money for their retirement and other life-goals, which wasn't the case until 2002. It was that year that state of Indiana decided to provide relief specific to such employees.

Care Select

Care Select provides health cover for Medicaid recipients with special needs. Individuals qualifying for Medicaid, but needing either special attention or special health care, will be able to access the Care Select program.

In order to pick the doctor and the clinic, you will have to select one of the Care Management Organizations (CMOs). These CMOs have special contract with the state to ensure that your special health needs are properly addressed. The CMO you pick will help you to modify and personalize health plan so that it can address your special health care needs adequately. The CMO will coordinate with you and Medicaid to ensure smooth processing of medical cover for people with specialized medical needs.

Care Select provides health cover for aged, blind, disabled, and foster children. In order to receive Care Select, applicant must have any of these medical conditions.

  • Asthma
  • Heart Failure
  • Diabetes
  • Congestive heart failure
  • Severe mental illness
  • Depression
  • Serious emotional disturbance for fosters and wards
  • Hypertensive heart disease
  • Hypertensive kidney disease
  • Rheumatic heart illness

In order to qualify, you will also have to meet other requirements for the program. If you qualify but choose not to be on Care Select, you can be on Traditional Medicaid.

When you qualify for Care Select, you will have to pick a health plan. Your doctor will assist you to choose the right plan but if you want to make the choice yourself, you will be free to do so.

If you are unsure what to choose, you can access this link from the official Health Care website.

You will have two plans available under Care Select:

  • Advantage: For more information on Advantage plan, you can call 1-800-784-3981
  • MDwise: For more information on MDwise plan, you can call 1-800-356-1204

Presumptive Eligibility (PE)

Those women who are pregnant but are on low-income and can't afford their own medical insurance, Medicaid provides health cover for them through its Presumptive Eligibility program. Presumptive Eligibility provides necessary medical cover while pregnant women wait for their Medicaid application approval.

Presumptive Eligibility cover is a temporary cover and it remains active only until the Medicaid application is approved. Presumptive Eligibility provides important healthcare for women during their early pregnancy so that they don't have to worry about their important medical needs while their Medicaid application is processing.

If a pregnant woman is already receiving Medicaid, then Presumptive Eligibility will not become available to such women. Moreover, income level for applicants should be below the level for Medicaid cover. To be eligible for Presumptive Eligibility, the following requirements need to be met.

  • Be a U.S citizen or a qualified alien
  • Be a resident of state of Indiana
  • Woman applying for Presumptive Eligibility will be required to provide proof of their eligibility
  • Women applying for Presumptive Eligibility should meet income criteria for Medicaid
  • Applicants should not be enrolled to Medicaid at the time of applying for Presumptive Eligibility. However, pending Medicaid status does not bar applying and receiving benefits under Presumptive Eligibility program.

Eligibility Requirements

Eligibility for Indiana Medicaid program can vary depending on the sub-program. These sub-programs include Traditional Medicaid, Hoosier Healthwise, Medicaid Waivers, Healthy Indiana Plan (HIP), MED works, Care Select, and Presumptive Eligibility programs. Individuals living in Indiana and seeking medical insurance through Medicaid will have to meet eligibility criteria according to the program category they fall in.

To determine your eligibility you will need to complete the eligibility screening tool. Please visit the tool at the link below:

Eligibility Screening Tool

If you need further help in determining your eligibility please contact your local Division of Family Resources (DFR). You can find your local DFR office by entering your zip code in the center of the page at the link below:

Division of Family Resources (DFR)

Please note, just because you may not meet the eligibility requirements for one of the Medicaid sub-programs, does not automatically mean you are ineligible for all available Medicaid programs.

Medicaid Application Instructions

There are three basic application methods for Indian's Traditional Medicaid. These are:

Apply in person: To apply in person, you will have to locate Division of Family Resources (DFR) office near you (enter your zip code in the center of the page). You can get the application form from the office and return it after completing it.

Apply online: You can apply online through Family and Social Services Administration application website. Once you are on the website, look for 'Apply for Benefits'. You will find complete instructions and online applications under this section.

Apply by phone: You can also apply for phone for Traditional Medicaid. Call at 1 800-403-0864 to start application process through phone.

When you are applying for Traditional Medicaid, you will need to provide certain information such as name and date of birth, social security number, income, other benefits you are getting, resources, monthly payments such as utility bills and mortgage payments etc. You will be required to provide this information for all the members of your household.

  • Apply for Medicaid Waivers
  • 1. Applying for intellectual and developmental disabilities

    You can apply in person by going to Bureau of Developmental Disabilities Services (BDDS) office near you. You can locate an office near you by using THIS link. You can also call at (800) 545-7763 to get more information about a BDDS office near you.

    2. Applying for Aged and Disabled, and Traumatic Brain Injury Waiver

    You can apply in person by locating the nearest Area Agency on Aging center. You will be required to apply for Medicaid under categories for Blind, Aged, or Disabled before you can apply for Waiver. You will have to apply for Medicaid at your local Division of Family Resources (DFR) office.

  • Apply for Hoosier Healthwise
  • Apply in Person: You can apply in person by visiting enrollment center near you. You can find a list of enrollment centers at THIS link. Once you have the application with you, you will just have to fill it and hand it over to proper authorities at the Enrollment Center.

    Apply by Mail: You can also apply through mail. In order to apply by mail, you will be required to get the application and then send it to address provided on the application form. You can ask for application to be sent through mail by calling your local office of Family Resources. Check this link for more information regarding Hoosier Healthwise applications.

  • Apply for Presumptive Eligibility (PE)
  • In order to receive benefits through PE program, you can apply at an approved clinic or doctor office. You will be required to take a pregnancy test if you don't have proof of your pregnancy from another doctor or clinic. After you fill the application and qualify for PE, your coverage will begin instantly.

    To find a clinic or doctor for PE, you can dial (800) 899-9949 and ask about your nearest approved clinic or doctor.

    You can also use this link to find more information related to PE.

  • Apply for Care Select
  • If you are looking to get aid through Care Select, you can't actually apply for it specifically. Once you are diagnosed with one of the diseases listed above, you can qualify for Care Select program.

    However, to receive benefits through Care Select, you will have to be Medicaid eligible. So if you are already Medicaid beneficiary and you are diagnosed with one of the diseases from Care Select diseases list, you are automatically enrolled for Care Select.

    On the other hand, if you are not enrolled in Medicaid but you have been diagnosed with one of the diseases mentioned above for Care Select, you can then enroll in Medicaid. After you qualify for Medicaid, you will start receiving benefits through Care Select.

  • Apply for M.E.D. Works
  • In order to receive benefits under this program, you will have to contact your local Division of Family Resources (DFR). You can find an office near you using THIS link.

    If you haven't applied for Medicaid already, you'll have to do it before you can be enrolled in M.E.D. Works program. Once you qualify for Medicaid, you can then apply for M.E.D. Works through your local DFR office.