If you or a loved one is covered by Indiana Medicaid, including:
- Traditional Medicaid
- Healthy Indiana
- Hoosier Healthwise
- Hoosier Care Connect
Take action now to help continue Medicaid eligibility.
During the COVID-19 federal public health emergency (PHE), due to federal requirements, Indiana Medicaid members were able to keep their coverage, regardless of a change in income, resources, or Medicaid category. That requirement ended on March 31, 2023. Throughout this year, all Medicaid members, including those who continued to receive Medicaid coverage solely due to the PHE, will be reassessed when their regularly scheduled redetermination is due.
For some Medicaid recipients this could result in actions to adjust, reduce or eliminate coverage.
It is important for Indiana Medicaid to have your current contact information and that you watch for and respond to any information you receive from Indiana Medicaid.
- Go to FSSABenefits.IN.gov
- Scroll down to the blue “Manage Your Benefits” section
- Click on either “Sign in to my account” or “Create account”
- Check that your contact information is accurate or create an account
- Call 800-403-0864 if you need assistance
- Watch your mail! Be sure to respond with any request for information
If you are told you no longer qualify, contact The Arc of Indiana at 317-977-2375. Our family advocates can determine if you can appeal the decision and/or explore alternate coverage options at HealthCare.Gov.
Learn More: Indiana Medicaid Information & Resources
Options for People Found Ineligible for Medicaid
Right to Appeal
Medicaid recipients who believe the decision to remove them from Medicaid is incorrect can request an appeal to contest the decision. In general, individuals can keep their Medicaid coverage while the hearing is pending.
- An appeal can also be made if Medicaid incorrectly assessed an individual’s or family’s income or incorrectly assessed a person’s disability status.
- People who no longer meet eligibility requirements for the Medicaid category they applied under initially may qualify under a different Medicaid category. State Medicaid agencies are required to automatically assess whether this is the case. However, it is important to know that people found ineligible due to a categorical change only have 13 days to appeal.
Important note: In some cases, a child receives Medicaid based on their disability, while the rest of the family receives Medicaid based on income. If Medicaid eligibility is lost due family income, it is important for families to monitor their child’s Medicaid status to make sure they do not loss their Medicaid coverage, or, if they receive Medicaid waiver services, they are not put in a category that is not Medicaid waiver compatible
Click here for information on Indiana’s appeals process.
Click here for additional information about Medicaid appeals.
Affordable Marketplace
Many people no longer eligible for Medicaid can enroll in an affordable Marketplace plan. Medicaid is required to transmit eligibility information directly to the Marketplace and, because losing Medicaid is a Qualifying Life Event, individuals will be able to enroll outside a regular enrollment period.
Children’s Health Insurance Program
Some children whose families lose Medicaid eligibility may be eligible for the Children’s Health Insurance Program (CHIP.) If the child is not eligible for CHIP, they are likely eligible for subsidized coverage through the marketplace.
Children’s Special Health Care Services
Children with certain qualifying conditions, whose family income is below 250% of the Federal Poverty Level, may qualify for Children’s Special Health Care Services, a state funded program that can pay certain costs associated with specific health conditions.
Other Considerations
Indiana provides 12 months of Medicaid postpartum coverage.
States are required to provide children with 12 months of continuous eligibility when they enroll in Medicaid or the Children’s Health Insurance Program (CHIP). This will help some children receive continuous coverage even when there are changes in the family’s income.
Many individuals who turned 18 during the pandemic did not apply for SSI. To apply, call 800-772-1213 (or TTY 800-325-0778 if you are deaf or hard of hearing) to make an appointment.
Families can learn more about navigating the SSI application process through The Arc of Indiana Academy Advocacy Training Program. Visit The Road to SSI, an In-Depth Look at the Application and Appeals Process.
Contact Us – We’re Here to Help
The Arc of Indiana’s family advocates are here to help with questions, guidance and resources.
Contact us at 317-977-2375 or 800-382-9100.