The Indiana Medicaid Program provides medical benefits to low-income individuals without medical insurance or adequate medical insurance. The Federal government establishes general guidelines for the administration of Medicaid benefits. There are specific eligibility requirements for receiving Medicaid benefits in Indiana.

Program NameIndiana Medicaid
Expanded MedicaidYes
Websitehttps://www.in.gov/medicaid/
Phone877-822-7196
Apply Onlinehttps://fssabenefits.in.gov/
Appeal a DenialMedicaid Appeals
Find a Local OfficeLocal DFR Offices

Eligibility Requirements

To be eligible for Indiana Medicaid, you must be a resident of the state of Indiana, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. Most non-disabled adults will be covered under the Healthy Indiana Plan (HIP).

Disabled individuals or those living in a Medicaid-certified institution may have higher income limits and are subject to an asset limit. Some categories require the payment of a monthly premium or contribution based on family size and income.

A disregard of 5% of the annual Federal Poverty Limit will be applied to family income for the Healthy Indiana Plan.

Annual Household Income Limits (before taxes)

Household Size*Maximum Income Level (Per Year)
1$16,971
2$22,930
3$28,888
4$34,846
5$40,805
6$46,763
7$52,722
8$58,680

*For households with more than eight people, add $5,958 per additional person.

Available Services Include:

Chiropractic servicesMental health care
Clinic servicesNon-emergency transportation
Dental careNursing facility services
Doctor visitsOver-the-counter drugs
Emergency transportationPhysical and occupational therapy
Family planning servicesPodiatry Services
Home health carePrescription drugs
Hospice careSubstance abuse services
Hospital careVision care
Lab and X-ray servicesWell-child visits
Medical supplies and equipmentWellness visit

Copayments


Traditional MedicaidHoosier Care ConnectHoosier Healthwise (Package C-only)
Non-Emergency Transportation$0.50 - $2.00$1 (each way)Non-covered
Emergency TransportationNo copayNo copay$10.00
Pharmacy (Generic)$3.00$3.00$3.00
Pharmacy
(Brand Name)
$3.00$3.00$10.00
Non-emergency use of ERNo copay$3.00No copay

Depending on your plan, the following copays may also apply:

Non-Preventive Physician Visit$4
Non-Emergency Use of ER$8
Inpatient Hospital Visit$75

Copays do not apply to:

  • Members who are pregnant
  • Members of Native American descent
  • Members who have already met their 5% cost sharing limit
  • Maternity services
  • Family planning services
  • Preventive care services