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2024-06-13

Indiana Medicaid Income Limits: Everything To Know

By
Team Member
Abby Care
Indiana Medicaid income limits vary by program and household size, ranging from 139% to 163% of the Federal Poverty Level. Learn more about eligibility and coverage.

Indiana Medicaid income limits are crucial in determining who can receive help from the program based on their income.

If you’re seeking medical assistance in Indiana, it’s important to understand how income limits can affect your eligibility as well as the type of Medicaid program you may qualify for based on your income. Here’s a quick look at everything you need to know about Medicaid income limits for Hoosiers.

Overview of Indiana Medicaid

Essentially, Medicaid makes sure people can get important medical help without having to worry about money. The program helps you with things like getting to medical appointments and paying for services.

Most adults who aren’t disabled can join the Healthy Indiana Plan (HIP), which covers medical services such as:

  • Doctor visits
  • Prescription medicine
  • Hospital stays
  • Dental care
  • Surgeries
  • Mental health care

Understanding Indiana Medicaid Income Limits

In simple terms, Indiana Medicaid income limits mean the most money you or your family can earn and still get help from Medicaid. Your income limit is based on the Federal Poverty Level (FPL), which changes depending on how many people are in your family.

Factors Affecting Income Limits

The amount of money you can make and still get Medicaid depends on things like your age, how many people are in your household, and if you have a disability. Here is a summary of the income limits based on age:

  • For adults aged 19-64, the income limit is 138% of the FPL, which is about $1,731 per month for a single person.
  • Pregnant women and children under 1 year old have an income limit of 213% of the FPL.
  • Children aged 1-5 years old and 6-18 years old have an income limit of 163% of the FPL.
  • Children under the Children’s Health Insurance Program (CHIP) have an income limit of 255% of the FPL.

Keep in mind that Indiana Medicaid income limits for adults aged 19-64 increase based on how many people are in the household. Here’s how it works:

  • If there’s just one person in the household, the income limit is $1,731 each month.
  • For every extra person in the house, the income limit goes up by $618 each month. This is because larger families might have more bills and need more money to qualify for Medicaid.

However, this adjustment only affects adults aged 19-64. For kids under 18 with disabilities, the income limit is decided by how much money they make alone. It doesn’t matter how many people are in the house.

If you have a disability or live in a medical institution approved by Medicaid, you might be able to earn more money and still get Medicaid, but there’s also a limit on your income and assets.

Types of Medicaid Programs Based on Income

There are various Medicaid programs available in Indiana, including:

  • Healthy Indiana Plan (HIP): This program is for people aged 19-64 in Indiana who don’t make a lot of money. It helps with medical costs and might cover dental and vision care.
  • Hoosier Care Connect: This is for older folks (aged 65 and older), blind people, or those with a disability in Indiana who don’t qualify for Medicare.
  • Hoosier Healthwise: For kids up to 19 and pregnant women in Indiana. It helps with medical, behavioral health, and dental care.
  • Medicare Savings Program (MSP): For people who don’t have much money and need help paying for Medicare prescriptions.
  • HoosierRx: For older people in Indiana aged 65 and over with a Medicare Part D plan who don’t have much money. It helps pay for Medicare Part D medications.

Determining Income Eligibility

  • Calculation Methods: Medicaid eligibility depends on how much money the applicant and their household members make compared to the FPL. All income sources, like earnings from jobs, are added up and compared to the income limits set by the state.
  • Household Composition Considerations: Who lives in your household is important for Medicaid eligibility. It includes the applicant, their spouse (if married), their kids (biological, adopted, and step), and their siblings (biological, adopted, and step). For pregnant people, it also includes the unborn child.
  • Documentation Required: To apply for Medicaid, you need to show proof of income, such as pay stubs, tax returns, and ID. If you’re pregnant you’ll also need proof of pregnancy.

Commonly Asked Questions

Who Qualifies for Indiana Medicaid Based on Income?

Indiana Medicaid depends on how much money you make compared to the Federal Poverty Level (FPL). To qualify, your income needs to be below a certain percentage of the FPL.

What Counts as Income for Medicaid Eligibility?

Income for Medicaid eligibility includes money you earn from working, payments from a former spouse, pensions, Social Security Disability Income, and other sources. However, some types of money, like what your spouse has in their IRA/401K, don’t count toward the income limit.

How Often Are Income Limits Updated?

Income limits for Indiana Medicaid eligibility are typically updated annually by the Department of Health and Human Services (DHHS) to keep up with changes in federal poverty guidelines or state regulations.

Application Process

Steps to Apply for Indiana Medicaid

  1. Check if you qualify for Indiana Medicaid. Then, gather important details like names, Social Security Numbers, income, and benefits received.
  2. Apply online through the Indiana Family and Social Services Administration (FSSA) Benefits Portal. Alternatively, visit a local DFR office or call 1-800-403-0864.
  3. Fill out and send in the Indiana Application for Health Coverage.
  4. It might take up to 90 days to know if you qualify. You can check your application status online or by calling 1-800-403-0864.

Resources Available for Assistance

If you need help with your Indiana Medicaid application, there are resources ready to assist you. Certified navigators are trained to guide you through the process, and the DFR offices also offer support.

Things to Avoid

When applying for Indiana Medicaid, remember to provide all required information and documents accurately. Remember to check your application’s status regularly to track its progress.

Additional Resources

The following resources provide valuable information and support:

  • Official Indiana Medicaid Website: You can find official information about Indiana Medicaid at www.in.gov/medicaid/members.
  • Local Medicaid Offices: To learn more about local Medicaid offices and the services they offer, you can visit the official Indiana Medicaid website mentioned.
  • Helplines and Support Services: If you need help or support, you can contact the following:
    • Member Services Phone Line: Call 1-800-457-4584 for assistance.
    • Enrollment Broker (Maximus) Phone Line:
      • For Healthy Indiana Plan (HIP): Call 877-438-4479
      • For Hoosier Care Connect: Call 866-963-7383
      • For Hoosier Healthwise: Call 800-889-9949
  • CareSource Member Services: Call 1-800-743-3333 for assistance

Conclusion

Medicaid is a huge lifeline for many low-income families, as it ensures they can get the healthcare they need. However, understanding Indiana Medicaid income limits is an important step for getting healthcare assistance through Medicaid.

If you’re looking to take part in the Attendant Care or Structured Family Caregiving program we can help guide you through the Medicaid journey! Abby Care is here for you!

Sources

https://www.benefits.gov/benefit/1072

https://www.in.gov/medicaid/members/apply-for-medicaid/am-i-eligible-for-medicaid/

https://www.medicaidplanningassistance.org/medicaid-eligibility-indiana/

https://www.healthinsurance.org/medicaid/indiana/

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