Medicaid Programs
There are several program options available under Indiana
Medicaid. Each program is designed to meet the medical needs
of a certain group of people. Each program has different
eligibility criteria; this means that a different set of measures
are used to determine if a person qualifies for that program. This
list provides a general overview of available programs. You
can learn more about each program by selecting a specific program
area.
Indiana's health care program for low income families, pregnant
women, and children. Based on family income, children up to age 19
may be eligible for coverage. The program covers medical care
like doctor visits, prescription medicine, mental health care,
dental care, hospitalizations, surgeries, and family planning at
little or no cost to the member or the member's family.
Program for low-income women who are pregnant and applying for
Medicaid. The presumptive eligibility program allows you to
receive important prenatal care while you wait for your Medicaid
application to be approved.
Care Select is a health care program that is designed to serve
Medicaid recipients who may have special health needs or benefit
from specialized attention. In Care Select, you pick a
primary doctor and a health plan by choosing one of the Care
Management Organizations (CMOs) contracted with the state to
coordinate your health care needs. The CMO will assist you in
coordinating your health care benefits and tailor them to your
individual needs, circumstances and preferences.
People served by Care Select may be aged, blind, disabled, wards
of the court and foster children, or children receiving adoptive
services. You 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
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.
Traditional Medicaid is a low-income healthcare program that
offers medical care such as doctor visits, prescription 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.
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.
Indiana offers five waiver programs that target specific
groups. Waiver services allow members to live in a community
setting and avoid institutional placement. To be eligible for
any waiver program, you must meet Medicaid guidelines and waiver
eligibility guidelines.
Two programs assist individuals who meet Nursing Facility level
of care:
- Aged and Disabled Waiver
- Traumatic Brain Injury Waiver
Three programs assist individuals who meet Intermediate Care
Facility for the Mentally Retarded (ICF-MR) level of care:
- Autism Waiver
- Developmental Disabilities Waiver
- Support Services Waiver