Understand Indiana Medicaid Redetermination (2024)

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Home &gt Medicaid Redetermination &gt Understand Indiana Medicaid Redetermination

Indiana Medicaid Renewals and Redeterminations: Coverage changes

Understand Indiana Medicaid Redetermination (1)

Beginning in 2023, Medicaid coverage in Indiana is no longer automatically renewing for all enrollees like it was during the COVID-19 pandemic. Things are returning to normal, and that could affect your health coverage with Indiana Medicaid, including the Healthy Indiana Plan (HIP). We can help you understand how to stay covered.

Understand Indiana Medicaid Redetermination (2)

Until recently, Medicaid coverage in Indiana continued, without eligibility checks, due to the COVID-19 federal public health emergency (PHE).

Now, states have been told to return to normal eligibility review processes. The Indiana Family and Social Services Administration (FSSA) is resuming regular eligibility review actions for Medicaid. That includes for the Healthy Indiana Plan (HIP) and the Children’s Health Insurance Program (CHIP).

How complete a renewal to keep your Medicaid coverage in Indiana

  1. Verify your contact information – Go to FSSABenefits.IN.gov and check that the contact information listed for you in the FSSA Benefits Portal is correct. You can also call 800-403-0864 if you need help.
  2. Keep an eye on your mailbox – If you are covered by Indiana Medicaid (including the Health Indiana Plan), you may need to fill out a redetermination (renewal) form. This will help the state determine whether you are still eligible for Medicaid.
  3. Respond to notices regarding your coverage – If you receive a notice, read it carefully to understand potential changes to your health coverage. Respond right away to any requests for information from the Indiana Family and Social Services Administration (FSSA). You should keep any notices you receive from the FSSA.
  4. Appeal the decision, if necessary – If you no longer qualify for Medicaid coverage, you will be mailed a final notice from the Indiana Family and Social Services Administration (FSSA). If you believe you are still eligible, you can appeal to try to keep health coverage. You can also reapply for Medicaid at any time.

(NOTE: The unwinding of continuous Medicaid coverage does not impact the Supplemental Nutrition Assistance Program (SNAP), although the additional pandemic-related SNAP benefits ended in February. And the scheduled end of the federal public health emergency on May 11, 2023, will affect SNAP eligibility for some people. Watch for letters and notices from your state to stay up-to-date on what you need to know about SNAP.)

No longer eligible to renew Medicaid in Indiana? You have options for health insurance in IN.

Get coverage through your jobSee moreGet an ACA Marketplace planSee moreSee if you qualify for financial helpSee moreSee if you qualify for MedicareSee more

Get coverage through your job

Understand Indiana Medicaid Redetermination (11)

If you decide to enroll in employer-sponsored coverage through your employer, or that of a spouse or parent, you’ll have a special enrollment window. The window typically lasts for 60 days when you lose Medicaid coverage.

Learn more about employer-sponsored health plans.

Understand Indiana Medicaid Redetermination (12)

Get an ACA Marketplace plan

Understand Indiana Medicaid Redetermination (13)

You will qualify for a special enrollment period in the federally facilitated Marketplace if you lose Medicaid coverage. That means you can apply for coverage immediately and do not have to wait for the annual enrollment window. Even if you no longer qualify for Medicaid, you may qualify for financial help to lower the cost of Marketplace health insurance.

Learn more about health insurance coverage options in Indiana.

Understand Indiana Medicaid Redetermination (14)

See if you qualify for financial help

Understand Indiana Medicaid Redetermination (15)

If coverage through your job is unaffordable, you may be eligible for financial help if you choose an ACA Marketplace plan instead of an employer-sponsored plan.

Calculate your potential subsidy savings.

Understand Indiana Medicaid Redetermination (16)

See if you qualify for Medicare

Understand Indiana Medicaid Redetermination (17)

You may qualify for Medicare, a federal health insurance program, if you are 65 or older. People younger than 65 may qualify if diagnosed with a permanent disability, including end-stage renal disease or Lou Gehrig’s disease (ALS). A special enrollment period is available to help you transition to Medicare when your Medicaid ends.

Learn more about Medicare coverage options in Indiana.

Understand Indiana Medicaid Redetermination (18)

Frequently Asked Questions about Indiana Medicaid redeterminations and renewals

When might I lose Medicaid coverage?

Medicaid renewals in Indiana will be conducted over a 12-month period that continues through the spring of 2024. Some people will not receive their renewal packet until later in that window, and their coverage will remain in place until their renewal is completed.

Indiana must conduct eligibility redeterminations for all Medicaid enrollees over the course of a 12-month period. So regardless of which program you’re enrolled in, your eligibility will be checked.

How can I check eligibility for Indiana Medicaid or the Healthy Indiana Plan?

The state ofIndianahas aneligibility guidethat covers basiceligibilityrules for programs including:

  • Traditional Medicaid or Hoosier Care Connect
  • Healthy Indiana Plan
  • Hoosier Healthwise(children and people who are pregnant)

(Note: If you’re enrolled in the Healthy Indiana Plan, CHIP, or M.E.D. Works, you have not had to makePOWER account contributionsor premium paymentsduring the pandemic. But those are expected to be collected againstarting in the summer of 2023).

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.

Additional resources for Hoosiers

Learn more about Medicaid eligibility and enrollment in IndianaWhat you need to know about Medicaid redeterminations and renewals

Indiana Family and Social Services Administration notification letters

Information from the Indiana FSSA about the return to normal

Understand Indiana Medicaid Redetermination (2024)

FAQs

Understand Indiana Medicaid Redetermination? ›

1 What is the redetermination process, and why do I need to go through it? By Federal law, Indiana Medicaid members must have their eligibility renewed every 12 months. This annual information-gathering process is used by the state to determine if you remain eligible for another year of coverage.

How to recertify for Medicaid in Indiana? ›

In Person.

Find the office nearest to you at https://www.in.gov/fssa/dfr/ebt-hoosier-works-card/find-my-local-dfr-office/. Turn in your completed renewal form and any other requested information at your local DFR. The state will send you a renewal notice when it is time to renew your coverage.

Is Indiana Medicaid changing in 2024? ›

Hoosiers 60 and over who are in nursing homes or who are receiving waiver services in the home will be required to join a Managed Care Entity (MCE) to receive their Medicaid services. Medicaid members will be allowed to choose their MCE early in 2024.

What is the monthly income limit for Medicaid in Indiana? ›

Income & Asset Limits for Eligibility
2024 Indiana Medicaid Long-Term Care Eligibility for Seniors
Type of MedicaidSingleMarried (both spouses applying)
Income LimitAsset Limit
Institutional / Nursing Home Medicaid$2,829 / month*$3,000
Medicaid Waivers / Home and Community Based Services$2,829 / month†$3,000
1 more row
Mar 7, 2024

What does redetermination mean in insurance? ›

The redetermination process, led by state agencies, involves reviewing Medicaid rosters and automatically renewing coverage for individuals that still qualify, based on benefits or other government data.

How do I check my Medicaid status in Indiana? ›

You can check the status of your application online or by calling 1-800-403-0864. You will need to have your case number to check the status of your application.

Does Indiana Medicaid expire? ›

Indiana Medicaid Renewals and Redeterminations: Coverage changes. Beginning in 2023, Medicaid coverage in Indiana is no longer automatically renewing for all enrollees like it was during the COVID-19 pandemic.

What is going on with Medicaid in Indiana? ›

During the COVID-19 federal public health emergency, due to federal requirements, Indiana Medicaid members were able to keep their coverage without interruption. The most recent federal spending bill ended Medicaid coverage protections, which means Indiana Medicaid is returning to normal operations.

What is the best Medicaid plan in Indiana? ›

HIP Plus is the preferred plan for all Healthy Indiana Plan (HIP) members. HIP Plus provides the best value coverage and includes more benefits. HIP Plus covers more, including vision, dental and chiropractic services, bariatric surgery and Temporomandibular Joint Disorders (TMJ).

Will Indiana Medicaid work out of state? ›

Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your Medicaid coverage when you're temporarily visiting another state, unless you need emergency health care.

Do you have to pay back Medicaid in Indiana? ›

When a Medicaid recipient dies, the State of Indiana is required by federal and state law to seek recovery from their estate funds equal to the amount used to pay for their medical expenses, including capitation payments made to a managed care entity on behalf of a member of the Healthy Indiana Plan.

Is Hoosier health Card the same as Medicaid? ›

Hoosier Healthwise (HHW) is one of the Indiana Medicaid programs. It is the State of Indiana's health care program for children, pregnant women, and families with low income. Based on family income, children up to age 19 may be eligible for coverage.

What are the three types of Medicaid offered in the state of Indiana? ›

Indiana Medicaid Members Home
  • Healthy Indiana Plan.
  • Hoosier Care Connect.
  • Traditional Medicaid.

What does redetermination mean in Medicaid? ›

Any party to the initial claim determination that is dissatisfied with the decision may request a redetermination. A redetermination is a review of the claim by Medicare Administrative Contractor (MAC) personnel not involved in the initial claim determination.

What is medical redetermination? ›

Medi-Cal Redetermination (also known as Medi-Cal Recertification, Medi-Cal Renewal, or Medi-Cal Unwinding) is the regular eligibility review that each local county office conducts to determine whether beneficiaries still qualify for Medi-Cal or Children's Health Insurance Plan (CHIP) coverage.

What does redetermination mean? ›

the process of deciding something again, for a second, third, etc. time: The contract for sale brought about a re-determination of the value of the equipment. The court ordered that the case should go back before the commission for redetermination. Fewer examples.

How do I contact Medicaid in Indiana? ›

If there are questions about this information, contact EDS Customer Assistance at (317) 655-3240 in the Indianapolis local area or 1-800-577-1278. The quick reference is also available on the IHCP Web site at www.indianamedicaid.com.

How do I report changes to Medicaid in Indiana? ›

They can update their information on the benefits portal (https://fssabenefits.in.gov) or by calling 800-403-0864.

What is the Medicaid state recovery in Indiana? ›

When a Medicaid recipient dies, the State of Indiana is required by federal and state law to seek recovery from their estate funds equal to the amount used to pay for their medical expenses, including capitation payments made to a managed care entity on behalf of a member of the Healthy Indiana Plan.

Does Indiana have retroactive Medicaid? ›

The Healthy Indiana Plan does not have retroactive coverage, so someone on HIP needs to take action to update their information as soon as possible. If they provide the needed information before the effective date of closure, then they can avoid a gap in coverage.

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