Indiana Medicaid

Apply online, by telephone, or by visiting a local Division of Family Resources Office. Locate an office by dialing 2-1-1 or calling the Indiana Family Helpline at 1-855-435-7178. Access the online application by visiting www.in.gov/fss a/dfr/2999.htm and clicking Apply for Benefits Online. What is Medicaid? Medicaid is a health insurance program. The program is funded by the state and federal government. It pays for necessary medical coverage for low income citizens. Several programs are part of Medicaid in Indiana. Some are Hoosier Healthwise, Care Select, C hildrens Health Insurance Program (CHIP), M.E.D. Works and Packages A, B or C. For these Medicaid programs eligibility is determined, in part, by income. It is a good idea to learn about the programs. Your child or family member may qualify for different programs at different times. What might my child(ren) qualify for? Program Ages Family income limits (see income chart on back) Up to 208% of poverty (0-1 yr); 158% FPL (1-18 yrs) Approximately 158-250% of poverty Cost Other eligibility requirements

Package A

Birth - 18

No-premiums; Low co-pays may apply Monthly premiums range based upon income and family size May not be eligible for employersponsored health insurance

Package C (CHIP) Children Only

Birth - 18

What about the adults in our family? Several programs provide coverage to adults who are caregivers of children who qualify for Medicaid. Program Ages Family income limits (see income chart on back ) Approximately 22% of poverty Up to 208% of poverty (include unborn child in family size) Up to 100% of poverty and not eligible for Package A. Cost Other eligibility requirements

To learn more about these and other programs, contact Family Voices Indiana. We will assist you as you navigate health care systems and services, especially those available to individuals with special health care needs.
317-944-8982 Fvindiana.org Page 1 of 2 Updated 12/2013

Package A

Package A (Pregnant Women) Healthy Indiana Plan (HIP)

Adult caregivers of children under 18 Pregnant Women

No premiums; Low co-pays may apply No premiums; Low co-pays may apply No more than 2% of gross family income. The amount will depend on income and family size. Must be a legal resident. Must submit a separate application, available here: http://www.in.go v/fssa/hip/index. htm.

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Family Planning Eligibility Program

Up to 141% of poverty, not otherwise eligible for Medicaid

To learn more about programs that cover children, call the Hoosier Healthwise Helpline,
1-800-889-9949

How to Apply You may submit an application for the programs described above by applying online (https://www.ifcem.com/CitizenPortal/application.do, click Apply for Health Coverage, SNAP, and/or Cash Assistance online) by phone 1-800-403-0864, or by visiting a local Division of Family Resources (DFR) office. Applications for Hoosier Healthwise may also be submitted at Enrollment Centers, which may be located by calling the Hoosier Healthwise Helpline 1-800-889-9949. To complete an application, you will need the following documents for each member of the household: Names and dates of birth Social Security number, proof of citizenship and/or immigration status Proof of income from jobs and training Information about tax filing status and dependents Proof of private medical insurance or any coverage for members of the household If anyone in the household is pregnant, a statement signed by a licensed health care professional or the name of the health care professional who can verify the pregnancy and the date the pregnancy began Income Limits All of the programs mentioned use the Federal Poverty Definition to set income limits. It is important to note that these limits are updated each year. Families whose income is close to a limit are encouraged to be aware of changes. Income eligibility is determined based upon the familys tax filing status and taxable income. For most programs, resource limits and nontaxable income, such as veterans compensation and child support, are no lon ger counted toward household income when determining eligibility. 2013-2014 Federal Poverty Guidelines Family Size 1 2 22% of Poverty $2,528 3,413 4,297 5,181 6,066 6,950 7,834 8,719 100% of Poverty $11,490 15,510 19,530 23,550 27,570 31,590 35,610 39,630 150% of Poverty $17,235 23,265 29,295 35,325 41,335 47,385 53,415 59,445 200% of Poverty $22,980 31,020 39,060 47,100 55,140 63,180 71,220 79,260 250% of Poverty $28,725 38,775 48,825 58,875 68,925 78,975 89,025 99,075

To learn more about the Healthy Indiana Plan (HIP), call

1-877-438-4479, or visit: http://www.in.go v/fssa/hip/index. htm.

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For More Information Contact Family Voices Indiana, Indianas Family to Family Health Information Center, supporting families who have children with disabilities and special health care needs as they navigate systems and services. Visit www.fvindiana.org or call 317.944.8982.

Please note: Programs and systems change often. It is important to ensure that you are using the most current information. This Fact Sheet was updated December 2013. Please check with Family Voices Indiana (www.fvindiana.org) for the most recent edition.