Learn About Coverage For Medicaid in Indiana

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What services are covered by Medicaid in Indiana? Medicaid services and equipment covered by the government-sponsored medical assistance program vary from state to state. The types of Medicaid insurance services provided by Indiana Medicaid are different from those provided in other parts of the country. Overall, Medicaid cost estimates differ across the nation and within each state.

For instance, while Medicaid coverage in IN will come with a monthly premium for some beneficiaries, others will not have to pay anything for necessary Medicaid services. For more information on Medicaid costs in Indiana, and for details on what is covered by Medicaid and what is not covered by Medicaid, continue to the following sections:

What Services are Covered by Medicaid in Indiana?

You might expect all types of Medicaid insurance to cover the same services and equipment. In fact, the federal government requires that every version of Medicaid coverage include a set of mandatory services. However, every state has its own version of Medicaid, including slightly different application steps.

When you go beyond the mandatory services, each state is free to develop its own mix of covered Medicaid services What services are covered by Medicaid in IN? Indiana Medicaid coverage pays for a wide variety of services and equipment for eligible beneficiaries. These Medicaid services include:

  • Doctor’s visits
  • X-ray and laboratory tests
  • Ambulance services
  • Emergency hospital services
  • Eye examinations
  • Dental services
  • Nursing home services
  • Emergency medical transportation
  • Occupational, physical and speech therapies
  • Hearing aids and services

It is important to note that children may be eligible for additional Indiana Medicaid services that adults will not qualify for, such as dental services. These services may include regular exams, teeth cleaning, X-rays or even oral surgery, in extreme cases.

Other medical services may be covered as well if your physician determines that they are medically necessary. If your Medicaid coverage plan denies a procedure or a piece of equipment, you can always appeal the decision. Your appeal rights are spelled out in the paperwork you received when you signed up for Medicaid in IN.

If you need a service deemed what is not covered by Medicaid, and need to file an appeal, you will need a prescription or a letter from your doctor. In addition, you may need some additional supporting documentation explaining why you need the service, how the service will benefit you, and what, if any alternative treatments are available.

What Does Medicaid Not Cover in Indiana?

While Medicaid coverage in Indiana insures beneficiaries for a number of helpful services, there are certain procedures and pieces of equipment that Indiana Medicaid will not cover. The Indiana Medicaid program establishes covered services based on medical necessity.

Therefore, any health service that is not medically necessary will not be covered in Indiana. The following medical services are decided as what is not covered by Medicaid:

  • Non-emergency transportation
  • Health services provided by relatives
  • Reconstructive, cosmetic and plastic surgeries
  • Obesity surgery without prior approval by Medicaid
  • Acupuncture
  • Foot care
  • Other services that Medicaid does not regard as essential

Even though your Medicaid coverage in IN will not pay for the above, you can still elect to book these medical services. However, you will be financially responsible to pay the fees out of your own pocket. Speak with your doctor and/or your medical coverage provider to discuss any payment plans available to you prior to booking a procedure or a treatment that is not covered by Medicaid types of insurance.

How Much Does Medicaid Cost in Indiana?

How much does Medicaid cost in Indiana? Many Medicaid beneficiaries pay no money at all for their state-sponsored health coverage, due to the fact that they earn low incomes. Medicaid in Indiana may cover 100 percent of your healthcare costs if your individual income is less than $981 per month.

For a couple, this threshold is $1,328 per month. In every case, your income has to be less than the income limits set by law in Indiana. In addition, you have to possess Medicaid hospital insurance.

If your income is above this threshold, you may still qualify for Medicaid, but you will have to pay a portion of the cost of your coverage. Unfortunately, there is no absolute answer to these types of Medicaid cost estimates. The amount you pay can change based on your income, the size of your household and the exact level of Indiana Medicaid coverage

If your IN Medicaid coverage does not handle your medical expenses 100 percent of the time, you can expect to pay low-cost bills. Since you are receiving Medicaid benefits due to the fact that you are not earning enough money to pay for healthcare on your own, your medical bills will never be exceptionally high. Expenses you may be responsible for include co-pays for doctor visits, co-pays for prescription drugs and low monthly Medicaid coverage premiums.

As stated earlier, medical procedures and treatments not covered by Medicaid are your responsibility. It does not matter if you are 100 percent covered by Medicaid, or if you are only receiving partial Medicaid coverage. In both of these scenarios, you are required to pay the cost out of your own pocket.

Once you are enrolled in Medicaid, you will have a better understanding of how to estimate Medicaid costs depending on your coverage plan.