UPDATE: For the year 2020, Medicaid plans will follow the same requirements and application methods.
What are the requirements for Medicaid in Indiana? If you are interested in obtaining Medicaid benefits for free or at a reduced cost, learning how to qualify for Medicaid in Indiana is your first step. The Indiana Medicaid program has a number of eligibility requirements before residents can start the application steps. Only those applicants who meet the Medicaid eligibility requirements may be accepted into the program.
Applicants who fall into different categories of income, living situations and disability may be subject to alternate criteria. To gain Indiana Medicaid benefits eligibility, you must meet all requirements that the state of Indiana has established, whether income-related or non-income-related.
What Are the Income Requirements for Medicaid in Indiana?
Who is eligible for Medicaid in Indiana? You meet the income requirements for Medicaid if you earn what is deemed by the state as a “low-income.” To obtain Medicaid benefits, a household’s income is required to meet Medicaid eligibility requirements in Indiana, which are based on the total income and the number of members in an applicant’s household.
This method of Medicaid eligibility in terms of income is the standard in every state that offers the Medicaid benefits program and is referred to as the Modified Adjusted Gross Income (MAGI) system. The Medicaid income requirements state that your household income must not exceed 138 percent of the Federal Poverty Level (based on your family’s size).
For instance, if you are a single-member household, if your annual income is less than $16,395, you will be eligible for Medicaid. If your household includes two individuals, your total household income must be less than $22,108 to qualify for Medicaid in Indiana. As the number of members in your household increases, your maximum allowable income increases, according to the following chart:
- 3 members: $27,821
- 4 members: $33,534
- 5 members: $39,248
- 6 members: $44,961
- 7 members: $50,688
- 8 members: $56,429
- 9 members: $62,169
- 10 members: $67,910
- 11 members: $73,651
- 12 members: $79,392
If your household has more than 12 members, you can simply add $5,741 for each additional member of your household. The total will determine the maximum income you may earn and still have Medicaid benefits eligibility from the Indiana program. You can be eligible for Medicaid as long as your income is below the threshold. Download our helpful guide to learn about the different requirements for Medicaid.
What Are the Non-financial Requirements for Medicaid?
What are the Medicaid application guidelines that are unrelated to income? The Medicaid program may also require prospective beneficiaries to meet various other qualifying criteria beyond the Indiana Medicaid eligibility requirements related to household income.
In general, only permanent residents, United States citizens, Indiana state residents, legal aliens or United States nationals can obtain Indiana Medicaid benefits eligibility. The medical insurance assistance or health care need also affects who is eligible for Medicaid; applicants must be considered in need of care and be considered low-income or very low-income.
Beyond the income, residency/citizenship and medical Medicaid eligibility requirements, certain groups of individuals are granted access to Indiana’s medical assistance benefits automatically. For instance, applicants who are 65 years of age or older can get medical assistance from the Indiana Medicaid program. In addition to elderly people, those Indianans who are blind and people who have other disabilities also receive automatic Medicaid benefits eligibility.
When you learn how to qualify for Medicaid in Indiana, you may wonder if any other groups are eligible to receive medical help. Each of the following groups of individuals can get Medicaid benefits.
You are eligible for Medicaid if you are pregnant or if you live in an intermediate care home or nursing facility. If you are younger than 21 years of age, you also qualify for Medicaid benefits. If you have been in the United States for a limited duration of time as a refugee, you can receive medical assistance, as well.
Participants of Breast and Cervical Cancer Treatment Programs meet Medicaid qualifications. Moreover, parents or caretakers of children younger than 21 can also be accepted as beneficiaries of Medicaid if the child’s parent is:
- Not living with the child
You can be accepted into this medical coverage program as long as you can provide proof of your income and your other eligibility qualifications upon application.
Learn About Other Programs
The information provided in the sections above clearly demonstrates that there are multiple methods available for how to qualify for Medicaid in Indiana. However, there is another way to determine who is eligible for Medicaid in IN. Applicants can qualify if they are already members of certain other accepted state programs. If you receive Supplemental Security Income (SSI) or Temporary Assistance for Needy Families (TANF), you are eligible for Medicaid in the state of Indiana.
If you receive benefits from any of these other programs within the state, you can also apply for Medicaid benefits. This will get you the medical help you need for your health and the health of every member of your household. Simply review the Medicaid eligibility requirements provided above concerning income, residency, citizenship and other factors to verify your qualifications before you submit an application to speed up the process.
If your application is deemed to be non-eligible, you may appeal the decision. In most cases, you will have 90 days. Once your appeal request is received, the Indiana Department of Health Care Services will make a ruling regarding your application within 45 days of its receipt.
In the event that your application is approved after the IDHW’s reconsideration, your household will begin to receive medical assistance benefits through the Medicaid program. Explore the different Medicaid requirements by downloading our informative guide.