Indiana Medicaid Guidelines & Eligibility

As the costs of health care continue to rise, many Indiana families are forced to go without health coverage. However, Indiana Medicaid offers free or low-cost coverage to more than one million people through a variety of programs for families, seniors, children and the disabled, allowing Hoosiers to access the health care they need.

Indiana Medicaid Plans

• The Hoosier Healthwise Plan offers low-income families, pregnant women and children up to age 19 health care for little or no cost. If you are on Medicaid and have a condition that requires specialized care, such as diabetes, cancer, asthma and certain mental issues, you may qualify for Care Select, which provides additional benefits. For those with disabilities who want to return to work, Medicaid for Employees with Disabilities, or MEDWorks, is a Medicaid program that provides low-cost health care benefits. Finally, traditional Medicaid pays monthly Medicare premiums for very-low-income seniors and provides benefits for refugees and other low-income residents who don't meet the qualifications of the other plans.

General Eligibility

• The eligibility requirements vary among Indiana Medicaid programs. In general, your eligibility is determined by your income, both earned from work and from other sources, such as Social Security Disability Income. Your age is also a factor, as each program serves a different population. Your available resources and assets can also affect your eligibility. Each program counts your assets differently, but in general, the amount of cash you have on hand in bank accounts, property other than your home, stocks and bonds, and the value of your vehicle after deductions count as assets. Your medical needs can also affect your eligibility, and a serious medical need or disability can qualify you for coverage.

Income Eligibility

• The income eligibility requirements for Medicaid programs vary by year and by individual programs. The only way to determine if you qualify for benefits is to apply, as the Indiana Family and Social Services Administration uses a complex series of formulas to determine your income. For example, as of 2011, a household with four people, including a pregnant woman, can qualify for the Hoosier Healthwise plan if the monthly gross income after deductions for childcare is less than $346.50. If a pregnant woman needs coverage for herself during the pregnancy only, her household income can be up to $3,675 per month, which is approximately twice the federal poverty level.

Healthy Indiana Plan

• Uninsured Indiana residents up to age 64 who have children and have not had health insurance for six months or more may qualify for the Healthy Indiana Plan. This is a Medicaid plan that provides medical coverage only for a small monthly fee. In order to qualify for this plan, your household income must be less than 200 percent of the federal poverty level for your household size. A family of four, as of 2011, can earn up to $44,700 per year and qualify for the Healhy Indiana Plan. The plan charges a premium of 2 to 5 percent of the family's income, based on the income amount and family size.