Who is eligible for
Indiana Medicaid?
Indiana Medicaid was created to
provide health care to the following groups of low income individuals:
Families with Children, Pregnant Women and Children, Aged, Blind and
Disabled. To be eligible for Medicaid in Indiana, a person must
belong to one of those groups and meet the financial criteria for that
group.
Members of Families with Children and
pregnant women may also be eligible for Hoosier Healthwise, the Medicaid
managed care program. To see if you qualify for Indiana Medicaid,
apply at your County Office of Family and Children, formerly known as the
County Welfare Office.
Indiana Medicaid Official Site
Members of Families with Children
Most Medicaid recipients are eligible because they meet most or all of
the requirements of the Temporary Assistance to Needy Families program (TANF),
formerly known as AFDC - Aid to Families with Dependent Children. The TANF
category of Medicaid eligibility includes not only those people who actually
receive TANF but also those who would receive TANF if their circumstances
were slightly different. This group of recipients is eligible for the
Hoosier Healthwise Managed Care program.
Pregnant Women and Children
The financial criteria are not as strict for pregnant women and children
under age 19. Pregnant women and children with family incomes at or just
above the federal poverty level may be eligible for Medicaid. This group is
often referred to as TANF-related, SOBRA or DEFRA. SOBRA and DEFRA are
acronyms that refer to the federal legislation that established these
additional Medicaid eligibility categories.
Aged
Individuals aged 65 or older are eligible for Medicaid if they meet the
financial criteria described in the "Medicaid Eligibility Overview." As a
result of the Medicare Catastrophe Coverage Act of 1988 (MCAA), the
financial criteria are more lenient if one spouse is in a nursing facility
while the other lives in the community.
In addition, people eligible for Medicare Part A may qualify to have
Medicaid pay their Medicare premiums, co-payments, and deductibles as a
Qualified Medicare Beneficiary (QMB), a Qualified Disabled and Working
Individual (QDW), or a Specified Low Income Medicare Beneficiary (SLMB).
Blind and Disabled
To be eligible for Medicaid in Indiana, a disabled person must have a
physical or mental impairment, a disease or loss that appears reasonably
certain to last for a continuous period of 12 months that substantially
impairs his/her ability to perform labor or services or to engage in a
useful occupation. Blind and disabled recipients may also be eligible for
the Medicare-related programs described above if they are eligible for
Medicare.
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