Indiana Medicaid

Enrollment

  • The distribution of Indiana Medicaid enrollment by beneficiary in 2011 was the aged (8%), the disabled (15%), adults (20%) and children (57%).

CHIP

  • The amount of children who were enrolled in IN Medicaid/CHIP in October 2014 was 704,816.
  • Children accounted for 58.8% of all Medicaid/CHIP enrollees in October 2014.

Costs Covered

  • In the 2012 fiscal year, the federal government covered 67% of Medicaid expenditures while the state of Indiana paid for 33%.
  • IN Medicaid spending by enrollee in 2011 was as follows: the aged (22%), the disabled (44%), adults (14%) and children (20%).

Medicaid Expansion

  • Indiana was one of 23 states to not approve of the Medicaid expansion in 2014.
  • Before the establishment of the Affordable Care Act, Indiana’s monthly Medicaid enrollment average was 1,120,674.
  • After the expansion of Medicaid, the IN Medicaid monthly enrollment average increased by 6.9% to 1,198,070.

1) What is Medicaid?

Indiana Medicaid is a state and federal program that offers low-cost or free health insurance to low-income Americans and legal immigrants who meet the state requirements. This program has become more important with the implementation of the Affordable Care Act and its individual mandate, which requires that every American citizen has health insurance.

If you do not want to purchase health coverage from the Health Insurance Marketplace, the Indiana Medicaid program is one option to consider. But, as mentioned before, there are multiple factors that go into determining whether or not someone is eligible, including:

  • Income (based on household size).
    • The larger a person’s household, the more income they can make and still be a member of Medicaid.
  • Medical needs.
  • Age.
  • Household size.

If, after filing a Medicaid application, you are not accepted into the medical assistance program, you will have to look elsewhere to purchase health insurance. But if you do become a member of Indiana Medicaid, then you will receive all of the below benefits and more:

  • Physician services
  • Screenings
  • Preventive care
  • Inpatient and outpatient care

In addition, all of the medical benefits will be available to you at a low cost or completely free of charge.

2) How do I apply for Medicaid in Indiana?

If you are wondering how to apply for Medicaid in Indiana, there are three methods that are available for you to employ. You can apply:

  • In person.
  • By phone.
  • Online.

In Person

If you would like to submit your Medicaid application in person, you will need to go to a local Division of Family Resources office. In order to locate a nearby office, you can click here for a tool that will provide you with the nearest addresses.

By Phone

If you would like to save time and apply for IN Medicaid by phone, you have the option to do so. Simply call 1-800-403-0834 and provide them with the information they request, and your eligibility for the Medicaid program will be determined.

Online

Applying for medical assistance online is the simplest and most convenient option you have available. You will have to follow the prompts and your application will be complete. To start today, click here.

Information You Need

Applicants will be asked to provide all of the following information for everyone that they are applying for:

  • Names
  • Birth dates
  • Social Security numbers
  • Income information
  • Employer information
  • Current benefits
  • Money and assets in accounts if blind, aged, disabled or on Medicare
  • Tax relationship information

3) What does IN Medicaid cover?

The state of Indiana features a Medicaid program with a wide variety of covered services. These treatments, surgeries and services cater to a wide variety of medical needs for all beneficiaries. Individuals and families who receive traditional Medicaid in Indiana will enjoy all of the following benefits:

  • Preventive care:
    • Family planning
    • Prescription medication
    • Physician visits
  • Emergency care:
    • Hospital admittance
    • Transport
    • Screenings that are considered medically necessary
  • Behavioral services and Mental Health services:
    • Doctor visits
    • Mental health center services
    • Social worker services
  • Diabetes self-care management:
    • Counseling for medication
    • Monitoring for blood glucose
    • Nutrition
    • Insulin injection
    • Foot care
    • Skin care
    • Dental care
  • Hospital care (inpatient and outpatient):
    • Lab exams
    • Rx medication
    • X-rays
  • Home health:
    • Durable medical equipment (DME)
    • Supplies for incontinence
  • Transportation to medical appointments
  • Dental care:
    • Annual exams
    • Preventive dental care
  • Vision care:
    • Eye exams
    • Eyeglasses
  • Pregnancy care:
    • Prenatal services
    • Delivery
    • Nursing midwife care

If you would like to receive quick access to all of the above services, then it is recommended that you file your IN Medicaid application today. For your convenience, you can apply online here.

4) Who is eligible for Indiana Medicaid?

There are a number of factors that determine whether or not an individual can receive medical assistance. To find out if you qualify for the program before you apply for Medicaid IN, the best thing to do is familiarize yourself with the requirements that you will have to meet. In general, there are four different categories that determine one’s eligibility:

Income and Household Size: The most important factor that the Indiana Medicaid agency takes into account is how much money you earn, including wages from your job and income from other sources, such as Social Security Disability earnings. The amount of money you earn is adjusted based on how many people make up your household. The limit on income for all residents does not take taxes into account and in the event that you are not eligible for Medicaid because of this, a five percent disregard will be applied to your situation.

Review the 2015 Indiana Medicaid income requirements below:

  • 1 person = $11,770
  • 2 family members = $15,930
  • 3 family members = $20,090
  • 4 family members = $24,250
  • 5 family members = $28,410
  • 6 family members = $32,570
  • 7 family members = $36,730
  • 8 family members = $40,890
  • Add $4,160 for each additional person for families with more than eight family members.

Medical Needs: Anyone that has specific care needs may be eligible for Medicaid because of a certain program. There are a number of medical assistance programs which cater to different medical needs.

Assets and Resources: Some possessions will be taken into consideration when you apply for Medicaid. The only exception to this rule is if the person in question is a child, a former foster child, parent with a low income, a pregnant woman or a beneficiary of family planning assistance.

Age: Some programs will only accept applicants from certain age groups.

5) What are the consequences if Indiana did not elect Medicaid expansion in 2014?

Included in the Affordable Care Act was the Medicaid expansion, which was one of its most important pieces of legislation. In 2014, it gave every state the choice to expand their Medicaid programs with federal funds. Those who chose to accept the expansion received federal money to augment their medical assistance programs. They would not have to pay any portion of the expanded Medicaid’s costs until the year 2016, when they would have to put in 10 percent of the spending. Twenty-seven states and the District of Columbia elected to accept the Medicaid expansion. Indiana did not.

By choosing not to expand their medical assistance program, Indiana is not allowing as many people to receive the low-cost or free health insurance of Medicaid IN. Within the state, an estimated 320,000 people would have gained access to the federal and state program. This would have been accomplished because the Medicaid augmentation focuses on accepting anyone with an income up to 133 percent of the federal poverty level.

Furthermore, children of families in similar financial circumstances would benefit in the same way. Across the country, millions of Americans do not have access to Medicaid simply because certain states chose to refuse the Obama administration’s offer to expand.

6) How do I contact Indiana Medicaid?

Individuals and families who have questions about the Indiana Medicaid program have multiple ways to get in contact with the overseeing agency for answers. The first way is to visit a local Division of Family Resources office and present your inquiries to a representative in person. They are trained to work with you to find answers and assist you in any way they can regarding your Medicaid application. To find a nearby Medicaid office, use the DFR locator.

If you would prefer to contact the IN Medicaid offices from your home, you also have the option of calling. The important thing to remember is that you must know what help line to call when you have a particular need.  For member services, as an example, you can call either 1-317-713-9627 or 1-800-457-4584. If you would like to get in contact with the pharmacy, call 1-855-577-6317. Additionally, when calling a Medicaid phone number, you should be able to provide a representative with the following information:

  • Your name
  • Your Social Security number (SSN) or your Medicaid Recipient Identification (RID) number
  • The SSN or RID of your dependent, if you are calling on their behalf

Finally, residents of Indiana also have the option to submit a question online through the IA Medicaid website. Simply fill out the form and press submit.

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