8/6/2019 FS Medicaid

http://slidepdf.com/reader/full/fs-medicaid 1/2

 

Apply at your

local Division of

Family

Resources

office. To find

your local

office, call

Indiana State

Information1-800-457-8283 

or

Indiana State

Dept of Health

Family Helpline

1-800-433-0746

To learn

more about

programs that

cover children,

call the Hoosier

Healthwise

Helpline

1-800-889-9949

To learn

more about

Healthy Indiana

Plan (HIP), call

1-877-438-4479

Page 1 of 2

Revised 5-10-11

What is Medicaid?Medicaid is a health insurance program. The program is funded by the state and federalgovernment. It pays for necessary medical coverage for low income citizens. Severalprograms are part of Medicaid in Indiana. Some are Hoosier Healthwise, Care Select,SCHIP, M.E.D. Works and Packages A, B or C. For these Medicaid programs eligibility is

determined, in part, by income. It is a good idea to learn about the different programs.Your child or family member may qualify for different programs at different times. 

What might my child(ren) qualify for?Program Ages Family income

limits(**see incomechart on back)

Cost Othereligibilityrequirements

Package A Birth - 18 Up to 150% ofpoverty

No-co pays May have limitsto family’sassets

Package C Birth - 18 Between 150%

& 250% ofpoverty

Monthly

premiumsrange from $22- $33 for onechild, and $33 -$55 for two ormore children

Must be

uninsured for atleast six monthsand cannot beeligible foremployer-sponsoredhealthinsurance

What about the adults in our family?Several programs provide coverage to adults who are caregivers of children who qualify fMedicaid.

Program Ages Family incomelimits(**see incomechart on back)

Cost Othereligibilityrequirements

Package A Adult caregiversof children under18

Up to 22% ofpoverty

none Must haveassets valuedat less than$1,000

Package B Pregnant Women Up to 200% ofpoverty

none

HealthyIndiana

Plan (HIP)

19 - 64 From 22 - 200%of poverty

No more than5% of your

gross familyincome. Theamount willdepend onincome andfamily size, andwill be reducedby the amountof any Medicaidpremium.

Must beuninsured for at

least six monthsand cannot beeligible foremployer-sponsoredhealthinsurance

Indiana Medicaid

8/6/2019 FS Medicaid

http://slidepdf.com/reader/full/fs-medicaid 2/2

 

Apply at your

local Division of

Family

Resources

office. To findyour local

office, call 

Indiana State

Information

1-800-457-8283 

or

Indiana State

Dept of Health

Family Helpline 

1-800-433-0746

To learn

more about

programs that

cover children,

call the Hoosier

Healthwise

Helpline

1-800-889-9949

To learn

more about

Healthy Indiana

Plan (HIP), call

1-877-438-4479 

Page 2 of 2

Revised 5-10-11

How to apply?Each local Division of Family Resources (DFR) office and Enrollment Center acceptsapplications for all of the programs described here. To find your local office call Indiana StInformation 1-800-457-8283; Indiana State Dept of Health Family Helpline 1-800-433-0746or go to http://www.in.gov/fssa/2954.htm. 

You will need the following information and documentation to complete the application(s):

Proof of Identity- for adults (can be a drivers license, State ID card, Social Security

card, or other pictureID) Proof of Income - a recent pay stub or other documentation from the employer

showing previous month's income. If there is income from other sources like SocialSecurity, then include some type of statement showing how much is being received

Social Security Numbers for those in your household Proof of Citizenship (can be a birth certificate) If the person applying is not a US citizen, you will need proof of immigration status

such as an immigration card or number. If the person applying has private health insurance, you will need proof of the privat

insurance, like an insurance card or the insurance policy number. If anyone in the household is pregnant, you will need something signed by a license

health care professional (doctor or nurse) or the name of the health care profession

who can verify the pregnancy and the date it began.

Income LimitsAll of the programs mentioned use the Federal Poverty Definition to set income limits. It isimportant to note that these limits are RESET each year. Families whose income is close ta limit are encouraged to be aware of changes. The following reflect ANNUAL income limifor 2011.

Family Size 100% Poverty 150% Poverty 200% Poverty 250% Poverty

1 $10,890 $16,335 $21,780 $27,225.00

2 $14,710 $22,065 $29,420 $36,775.00

3 $18,530 $27,795 $37,060 $46,325.00

4 $22,350 $33,525 $44,700 $55,875.00

5 $26,170 $39,255 $52,340 $65,425.00

6 $29,990 $44,985 $59,980 $74,975.00

7 $33,810 $50,715 $67,620 84,525.00

8 $37,630 $56,445 $75,260 94,075.00

Where to get more information:Several organizations assist families in understanding and applying for these programs. Foassistance please contact:

Covering Kids & Families of Indiana, a statewide organization committed to ensurinthat all children and families eligible for Medicaid and the State’s Children’s HealthInsurance Program (SCHIP) are enrolled. Visit www.ckfindiana.org or by phone574-472-4308.

Programs and systems change often. It is important to ensure that you are using the

most current information. This Fact Sheet was updated on May 10, 2011. Please

check with http://earlychildhoodmeetingplace.org for the most recent edition.

Supported in part by project H25 MC 00263 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services

Administration, Department of Health and Human Services