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
Hoosier Healthwise is Indiana's health care program for low
income parents/caretakers, 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.
Hoosier Care Connect is a health care program for individuals
who are aged 65 years and older, blind, or disabled and who are
also not eligible for Medicare. In Hoosier Care Connect, you
select a health plan that works with you and your doctor to
understand your health care needs. These health plans will
make sure that you get the most appropriate care based upon your
Hoosier Care Connect covers a variety of individuals who are not
eligible for Medicare, including:
- Aged individuals;
- Blind individuals;
- Disabled individuals;
- Individuals receiving Supplemental Security Income (SSI);
- Individuals enrolled through M.E.D. Works.
M.E.D. 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. M.E.D. Works is a
program designed to allow disabled employees to work without fear
of losing their Medicaid. M.E.D. 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, M.E.D. Works may be the program that would be best for
The Healthy Indiana Plan (HIP) covers adults age
19-64 whose incomes are less than approximately 138% of the federal
poverty level and who are not eligible for Medicare or another
Indiana Medicaid category. HIP requires you to make a
minimal monthly contribution to your coverage based on the amount
of your income. For more information about the Healthy
Indiana Plan, click here.
Traditional Medicaid is a low income health care program that
offers coverage for medical services, 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 or are refugees.
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. Indiana offers five waiver programs that target
specific groups: the Aged and Disabled Waiver, the Traumatic Brain
Injury Waiver, the Community Integration and Habilitation Waiver,
the Family Supports Waiver, and the Psychiatric Residential
Treatment Facility Transition Waiver.
Presumptive Eligibility (PE) is a process that offers short-term
coverage of services. The program is available to children,
parents/caretakers, and other adults. The goal of the program
is to make sure you have immediate access to health care..
Your short-term coverage will end if you do not complete a
Presumptive Eligibility for Pregnant Women (PEPW) offers
temporary coverage of prenatal care services to pregnant women
while their Medicaid applications are pending. The goal
of PEPW is to offer health care to women early in their
pregnancies, so they stay healthy and have healthy babies.
Presumptive Eligibility means that we presume you are eligible for
the Hoosier Healthwise program based on some preliminary
information that you provide.
The Family Planning Eligibility Program is a program allowing
men and women the ability to receive certain family planning
services. The Family Planning Eligibility Program provides services
and supplies to men and women for the primary purpose of preventing
or delaying pregnancy.
Indiana Medicaid has three programs for individuals with serious
mental illness, emotional disturbance, and substance use disorders
that help them remain in the community. These programs are
the Child's Mental Health Wraparound (CMHW), the Behavioral &
Primary Healthcare Coordination (BPHC), and the Adult Mental Health
and Habilitation (AMHH) programs.