Medicaid in Indiana is a joint federal and state program designed to provide health care coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. The program is administered by the Indiana Family and Social Services Administration (FSSA), which oversees a variety of benefits, including doctor visits, hospital stays, long-term care services, and preventive care.

Indiana has implemented several unique features in its Medicaid program, notably the Healthy Indiana Plan (HIP) 2.0, which was introduced as an alternative to traditional Medicaid expansion under the Affordable Care Act. HIP 2.0 includes POWER accounts (Personal Wellness and Responsibility Accounts), designed to encourage healthy behaviors and personal responsibility among participants.

Additionally, the program offers various levels of coverage, including HIP Plus, HIP Basic, and HIP State Plan Plus, tailored to meet the specific needs of different population groups. Through these initiatives, Indiana aims to improve access to healthcare services while promoting individual accountability and efficient use of resources.

Medicaid in Indiana covers a wide range of services to meet the healthcare needs of its enrollees. Here's an overview of some vital covered services, each with a brief description:

1. Doctor Visits: Regular check-ups and consultations with healthcare professionals to manage health and diagnose issues early.
2. Hospital Services: Inpatient and outpatient medical, surgical, and emergency services.
3. Prescription Drugs: Medications a doctor prescribes, including generic and some brand-name drugs.
4. Laboratory and X-ray Services: Diagnostic tests and imaging services to help diagnose and treat medical conditions.
5. Mental Health Services: Counseling, therapy, and psychiatric services for mental health and substance abuse issues.
6. Dental Services: Preventive, diagnostic, and treatment services for teeth and gum health, although coverage may vary by age and specific program.
7. Vision Services: Eye exams and, in some cases, coverage for glasses or contact lenses.
8. Long-Term Care Services: Services for individuals who need ongoing assistance with daily living activities due to chronic illness or disability, including nursing home care and home-based services.
9. Rehabilitative Services: Physical, occupational, and speech therapies to help recover from an illness or injury.
10. Preventive Care: Screenings, immunizations, and wellness visits to prevent diseases and detect health issues early.
11. Family Planning Services: Services and supplies to help individuals plan and space pregnancies, including contraception and fertility treatments.
12. Maternity and Newborn Care: Healthcare services for pregnant women and their newborns, including prenatal, delivery, and postnatal care.
13. Emergency Services: Medical attention for emergency conditions where delaying care could result in serious harm.
14. Transportation Services: Non-emergency transportation to and from Medicaid-covered services for eligible individuals with no other transportation means.

Each of these services is designed to ensure comprehensive healthcare coverage for Medicaid recipients in Indiana, aiming to improve health outcomes and access to necessary care.

Eligibility for Medicaid in Indiana is determined by various factors, including income, household size, and specific individual circumstances such as disability status, age, and whether a person is pregnant. The state uses the Federal Poverty Level (FPL) as a guideline to determine financial eligibility for different groups. Here's an overview of the eligibility levels by percentage of the FPL for key groups under Indiana Medicaid, including the Healthy Indiana Plan (HIP) 2.0, as of my last update:

1. Adults (19-64) without Dependent Children (Healthy Indiana Plan 2.0): Eligible if income is up to 138% of the FPL.
2. Pregnant Women: Coverage is available for pregnant women with incomes up to 208% of the FPL.
3. Children (under 19): Eligibility for the Children's Health Insurance Program (CHIP, part of Medicaid in Indiana) extends to children with household incomes up to 250% of the FPL.
4. Parents/Caretakers of Dependent Children: The income threshold for this group can vary but typically falls below 138% of the FPL, with specific criteria depending on family dynamics and household size.
5. Individuals with Disabilities: Those who qualify under the Supplemental Security Income (SSI) criteria or other specific disability determinations may be eligible for Medicaid regardless of income, with certain asset and income limits considered.
6. Elderly (Age 65 and Older): Eligibility for this group is also determined based on income, assets, and whether they meet criteria for Medicare, with specific Medicaid programs available to assist with Medicare premiums and out-of-pocket costs for those with incomes up to 135% of the FPL (Medicare Savings Programs).
7. Long-Term Care Medicaid: Financial eligibility includes income and asset tests for individuals needing long-term care, with income typically capped at 300% of the federal benefit rate for SSI recipients.

These eligibility criteria can change yearly due to policy updates or adjustments in the FPL. Indiana also considers assets and other non-financial criteria for specific categories of Medicaid applicants. The state may have additional programs or waivers that adjust these eligibility levels to particular populations or services. For the most current and detailed eligibility information, contacting the Indiana Family and Social Services Administration (FSSA) or visiting their website is recommended.

Applying for Medicaid in Indiana can be done through several methods, ensuring accessibility for all applicants. Here are the specific steps and contact information to guide you through the process:

Online Application

You can apply online through the Indiana Family and Social Services Administration (FSSA) Benefits Portal at https://fssabenefits.in.gov/. This method is the fastest and most convenient way to apply for Medicaid, allowing you to submit your application and track its status.

In-Person Application

You can apply in person by visiting your Local Division of Family Resources (DFR) office. To find the nearest office, visit the FSSA website or use the FSSA office locator tool at https://www.in.gov/fssa/dfr/office-locator/. This option benefits those who prefer face-to-face assistance or have specific questions.

Application by Mail or Fax

Applications can be downloaded from the FSSA website. After filling out the application, you can mail it to your local DFR office or fax it. The mailing address and fax number will be specific to your local DFR office, which can be found on the FSSA office locator tool.

Phone Application

You can apply by phone by calling the FSSA at 1-800-403-0864. This option is suitable for those needing internet access or prefer speaking to a representative. The call center can guide you through the application process and answer any questions.

Regardless of the method chosen for application, you will need to provide certain information and documents, including, but not limited to:

• Personal identification (e.g., driver's license, state ID)
• Social Security numbers for all applying members
• Proof of income (e.g., pay stubs, tax returns)
• Proof of residency in Indiana
• Information on any other insurance coverage

After you submit your application, the FSSA will review it to determine your eligibility. You may be contacted for additional information or to clarify details in your application. Once your application is processed, you will receive a notification regarding your eligibility status and the next steps.

For assistance throughout the application process or to get more information, you can contact the FSSA directly or seek help from various non-profit organizations in Indiana that offer support to individuals applying for Medicaid.

This information provides a comprehensive overview of how to apply for Medicaid in Indiana, ensuring you have the necessary resources and guidance to begin the application process.

Renewing Medicaid coverage in Indiana is important to ensure no interruptions in your healthcare services. Medicaid eligibility is reviewed periodically, typically once a year, to verify that enrollees still meet the eligibility criteria. Here's what you need to know about the renewal process and how to complete it:

The Indiana Family and Social Services Administration (FSSA) will notify you about your upcoming Medicaid renewal date. This notice is usually mailed to you 60 days before your coverage is set to expire. It's crucial to keep your contact information updated with FSSA to ensure you receive this notification.

How to Renew

1. Online: The easiest way to renew your Medicaid coverage is through the FSSA Benefits Portal at https://fssabenefits.in.gov/. You must log in to your account (or create one if you haven't already) and complete the renewal process following the instructions provided.
2. In Person: You can visit your local Division of Family Resources (DFR) office to renew your Medicaid coverage. To find your nearest office, use the office locator tool at https://www.in.gov/fssa/dfr/office-locator/. This option allows you to get assistance from a representative and ask any questions you might have.
3. By Mail: If you received a renewal form by mail, you could complete it and send it back to the address provided in the renewal notice. If you need a new form, you can download it from the FSSA website or request one from your local DFR office.
4. By Phone: Call the FSSA at 1-800-403-0864 to renew your coverage over the phone. This method is helpful for those who prefer speaking directly to a representative who can guide them through the renewal process.

To renew your Medicaid coverage, you will typically need to provide updated information about your income, household size, and any changes in your circumstances since your last application or renewal. Having recent pay stubs, tax returns, and other relevant financial documents on hand is a good idea.

After you submit your renewal application, FSSA will process it and notify you of their decision. If your coverage is renewed, you will receive information about your eligibility and any changes to your benefits. You may be asked to provide additional information if there are issues with your renewal.

Renewing your Medicaid coverage on time is crucial to maintaining your health benefits without interruption. Following the steps outlined above and preparing your documents in advance can ensure a smoother renewal process.