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Indiana Medicaid

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 Name Indiana Medicaid
Expanded Medicaid Yes
Website https://www.in.gov/medicaid
Phone 877-822-7196
Apply Online https://fssabenefits.in.gov
Appeal a Denial Medicaid Appeals
Find a Local Office Local 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 services Mental health care
Clinic services Non-emergency transportation
Dental care Nursing facility services
Doctor visits Over-the-counter drugs
Emergency transportation Physical and occupational therapy
Family planning services Podiatry Services
Home health care Prescription drugs
Hospice care Substance abuse services
Hospital care Vision care
Lab and X-ray services Well-child visits
Medical supplies and equipment Wellness visit

Copayments

Traditional Medicaid Hoosier Care Connect Hoosier Healthwise (Package C-only)
Non-Emergency Transportation $0.50 – $2.00 $1 (each way) Non-covered
Emergency Transportation No copay No copay $10.00
Pharmacy (Generic) $3.00 $3.00 $3.00
Pharmacy
(Brand Name)
$3.00 $3.00 $10.00
Non-emergency use of ER No copay $3.00 No 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

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