Indiana Medicaid Eligibility Calculator 2025
Instantly estimate your potential eligibility for Indiana health coverage based on 2025 income limits. This tool is for informational purposes only.
Frequently Asked Questions 2025
What are the income limits for Indiana Medicaid in 2025?
Indiana Medicaid income limits vary by category. Adults ages 19-64 qualify up to 138% FPL ($1,800/month single). Pregnant women: 213% FPL ($2,778/month single). Children under 1: 208% FPL ($2,713/month). Children ages 1-18: 158% FPL ($2,061/month). Income limits increase with household size.
Can I qualify for Indiana Medicaid if I'm working?
Yes. Healthy Indiana Plan (HIP) Basic covers working adults earning up to 100% FPL. HIP Plus extends to 138% FPL with earned and unearned income counted. M.E.D. Works allows working individuals with disabilities to earn up to 350% FPL while maintaining Medicaid coverage with monthly premiums.
What does Indiana Medicaid count as income?
Counted income includes wages, salaries, net self-employment income, Social Security SSDI, pensions, rental income, interest, dividends, alimony, and child support. SSI is not counted under MAGI rules. Capital gains and certain American Indian trust distributions are excluded.
Who is eligible for Indiana Medicaid besides low-income adults?
Eligibility includes children through age 18, pregnant women, individuals age 65+, blind individuals, disabled persons, former foster children under 26, and caretakers of eligible children. Each group has specific income and categorical requirements. Coverage varies by program and circumstances.
How do I apply for Indiana Medicaid in 2025?
Apply online via FSSA Benefits Portal (www.fssabenefits.in.gov), by phone (1-800-403-0864), in-person at local DFR offices, or by mail. Complete applications are processed within 90 days. Pregnant women may receive temporary Presumptive Eligibility while applications process, with coverage backdated to application date.
What documents do I need to apply for Indiana Medicaid?
Required documents include proof of identity (driver's license, birth certificate), Indiana residency proof (utility bill, lease), income verification (pay stubs, tax returns, benefits statements), Social Security number, citizenship/immigration status proof, and asset information for aged/blind/disabled categories. Specific requirements vary by situation.
Does Indiana Medicaid cover dental, vision, and prescription drugs?
Yes—coverage depends on program. Hoosier Healthwise Package A (full Medicaid) covers dental, vision, prescription drugs, mental health, and therapy at no cost. HIP Plus includes dental, vision, and $0 copays for prescriptions. HIP Basic covers prescriptions with $4-$8 copays. Traditional Medicaid covers all services.
What services are NOT covered by Indiana Medicaid?
Generally not covered: routine foot care (except surgical), non-emergency transportation (varies by program), experimental treatments, cosmetic procedures, and services without medical necessity. Hoosier Healthwise Package C excludes nursing facility and hospice care. HIP Basic excludes non-emergency transportation and rehabilitation options.
When do I need to renew my Indiana Medicaid in 2025-2026?
Annual redetermination is required every 12 months. You'll receive renewal notice 45 days before expiration. Submit within 45 days to avoid coverage gap. Children under 19 have 12-month continuous eligibility regardless of changes. Pregnant/postpartum women and SSI recipients may have different timelines.
What happens if I miss my Indiana Medicaid renewal deadline?
Coverage ends if renewal isn't submitted within 45 days of notice. Gap in coverage applies until eligibility is redetermined. If 90+ days pass after coverage ends, you must reapply completely. Report changes (income, address, family size) immediately to avoid disenrollment. Update via online portal, phone, or mail.