Am I eligible?
Medicaid eligibility is determined by several factors and can be
complicated. There are many categories of eligibility and
several different Medicaid programs. Please review all of the
eligibility information and if you think you may be eligible, the
best thing to do is apply. While different Medicaid programs
have different eligibility criteria, in general four main criteria
are used to determine eligibility.
- Income/Family Size: Both
earned (wages from a job) and unearned income (Social Security
Disability payments). Income limits are adjusted to account for the
number of people in your family.
- Age: Eligibility criteria can be based on age.
Certain programs are designed for people in specific age
groups.
- Resources/Assets: Certain things you have are
taken into consideration when determining eligibility. Different
programs count different resources/assets.
- Medical Needs: Specific medical needs may
determine your eligibility and they may also determine which
program can best serve your needs. Some programs are designed to
meet the medical needs of a targeted group.
What program Might be right for me?
The following list of Medicaid programs can give you an idea of
which program might be right for you. You can also go to the
Eligibility Guide to get detailed information on eligibility
criteria.
Hoosier Healthwise
Indiana's health care program for children, pregnant women, and
low-income families. There are several different program packages
under Hoosier Healthwise that are tailored for specific groups of
people.
*If you are a pregnant woman, you may be able to get coverage
immediately under a program called Presumptive Eligibility.
This will allow you to receive important prenatal care while your
Medicaid application is being processed.
Care Select
Indiana's health care program to serve individuals who may have
special health needs or benefit from specialized attention.
People served by Care Select may be aged, blind, disabled, wards of
the court and foster children, or children receiving adoptive
services. Individuals must also have one of the
following medical conditions:
- Asthma
- Diabetes
- Heart Failure
- Congestive Heart Failure
- Hypertensive Heart Disease
- Hypertensive Kidney Disease
- Rheumatic Heart Illness
- Severe Mental Illness
- Serious Emotional Disturbance (SED) for Wards and Fosters
- Depression
Healthy Indiana Plan (HIP)
The HIP plan covers individuals who do not live
with a dependent child, and parents who earn up to
approximately $44,000 annually for a family of four,
have been uninsured for six months and do not have access to
insurance through their employer. HIP may require you to
pay a small monthly fee based on the amount of your income.
HIP does not cover vision, dental or maternity services. More
information about the HIP program can be found at www.in.gov/fssa/hip/index.htm
Traditional Medicaid
Traditional Medicaid is a low-income healthcare program that
offers medical care such as doctor visits, prescribed drugs, dental
and vision care, family planning, mental health care, surgeries and
hospitalizations. The Traditional Medicaid program is for
individuals who have both Medicaid and Medicare, have a spend
down/monthly deductible, or are refugees.
Waiver
Waiver services are for individuals of any age who have special
medical needs. Waiver services allow members to live in a
community setting and avoid institutional placement. To be
eligible for any waiver program, you must meet both Medicaid
guidelines and waiver eligibility guidelines. Indiana offers five
waiver programs that target specific groups. The Aged and Disabled
Waiver, The Traumatic Brain Injury Waiver, The Developmental
Disabilities Waiver, The Autism Waiver, and the Support Services
Waiver.
M.E.D. Works
MED Works is Medicaid for Employees with Disabilities. Many
disabled people feel that they may be able to return to work, but
are fearful of losing their Medicaid benefits. MED Works is a
program designed to allow disabled employees to work without fear
of losing their Medicaid. MED Works offers the same coverage levels
as regular Medicaid. There may be small monthly premiums based on
the amount of money a worker earns. If you are receiving SSDI and
no cash benefits and feel that you may be able to return to work,
MED Works may be the program that would be best for you.
How do I apply?
The Division of Family Resources (DFR) is the group that
determines eligibility for all Indiana Social Services Programs.
The DFR will assist you in determining which programs are right for
you and your family. You can learn more about the application
process by going to Apply for Medicaid.