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.
Hoosier Healthwise is 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.
Presumptive Eligibility (PE) is a 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 Healthy Indiana Plan
covers individuals who do not live with a dependent
child and parents who earn up to
approximately $46,100 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 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, have a spend down/monthly deductible, or are
refugees.
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
you.
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.
The Family Planning Eligibility Program is a new 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.