Eligibility Guide
Eligibility Guide
Please select the category that best describes you or the person who needs medical coverage.
This is only a guide and is intended to show basic eligibility rules for several typical Medicaid member groups. You must apply for coverage to know for sure whether you qualify.
Note: The following income limits include income before taxes and not take-home pay.
- Pregnant Individuals
Program options
Pregnant individuals typically fall into the Hoosier Healthwise program. Please review all eligibility criteria below.
Eligibility factors
- Pregnancy
- Income
- Family size
Income / family size
Family size Income limit (per month) Additional details 2 $3,628.00 Family size is based on the tax household, including the unborn child(ren). If you do not file taxes, the household includes the pregnant individual, their child(ren) (biological, adopted, and step), their unborn child(ren), and their spouse, if married.
These income standards are effective March 1, 2024.
3 $4,583.60 4 $5,538.00 5 $6,493.45
You can receive immediate medical attention by applying for Presumptive Eligibility for Pregnant Women while you wait for your Medicaid application to be completed. - Children
Program options
Children who are not disabled and not living in an institution will be served through Hoosier Healthwise. If your child is disabled or living in an institution, please refer to the aged, blind, and disabled section.
Eligibility factors
- Age - These programs serve children through the age of 18.
- Current health insurance coverage - Having private insurance may affect eligibility.
- Income - See limits below.
Income / family size
Family size Income limit (per month) Additional details 1 $3,137.50 Family size is based on the tax household. If you do not file taxes, the household includes the child(ren), the child(ren)'s parent(s) (biological, adopted, and step), and the child(ren)'s sibling(s) (biological, adopted, and step).
These income standards are effective March 1, 2024.
2 $4,258.33 3 $5,379.17 4 $6,500.00 5 $7,620.83 Based on income, you may have a monthly premium. You can learn more about the premiums by visiting the Hoosier Healthwise and M.E.D. Works premium payments webpage.
- Adults
Program options
Generally, adults who are not disabled or institutionalized will be served through the Healthy Indiana Plan. If you are disabled or living in an institution, please refer to the aged, blind, and disabled section.
Eligibility factors
- Age - Individuals must be age 19 or older.
- Current health insurance coverage - Having private insurance may affect eligibility.
- Income - See limits below.
Income / family size
Family size Income limit (per month) Additional details 1 $1,670 Family size is based on the tax household. If you do not file taxes, the household includes the child(ren), the child(ren)'s parent(s) (biological, adopted, and step), and the child(ren)'s sibling(s) (biological, adopted, and step).
These income standards are effective March 1, 2024.
2 $2,266 3 $2,862 4 $3,458 5 $4,055 If eligible for HIP, you will be required to make a monthly contribution of 2% of your family income to receive HIP Plus benefits. To learn more about HIP Plus and HIP Basic, visit the Healthy Indiana Plan webpage.
- Aged, Blind, and Disabled
Program options
Individuals who are aged, blind, or disabled, including those who are institutionalized, will be served through one of the following programs:
- Traditional Medicaid
- Hoosier Care Connect
Eligibility factors
- Age - Most programs serve individuals of all ages.
- Disability status - If disabled, your disability must meet the definition of the Social Security Administration.
- Income and assets - See limits below.
Income / family size
Family size Income limit (per month) Additional details 1 $1,255 Family size is based on the tax household. If you do not file taxes, the household includes the child(ren), the child(ren)'s parent(s) (biological, adopted, and step), and the child(ren)'s sibling(s) (biological, adopted, and step).
These income standards are effective March 1, 2024.
2 $1,704 3 $2,152 4 $2,600 5 $3,049 Disabled individuals who are institutionalized or eligible for Home and Community-Based Waiver services may qualify with monthly income of up to $2,742. This income standard is based on the individual only; income of the spouse and other household members is not counted. Depending on their countable income, these individuals may be responsible for paying a monthly patient or waiver liability.
Working disabled individuals may be eligible for M.E.D. Works with slightly higher income and will be required to pay a monthly premium.
Institutionalized, disabled individuals may be eligible with slightly higher incomes and be required to pay a monthly patient liability.
Asset test
Maximum of $2,000 (single) or $3,000 (married) in assets.
What is counted as an asset? This includes items such as a bank account balance, cash on hand, stocks and bonds, and property (other than your family home).
What does not count as an asset? One vehicle, a home (if it is where you live), and burial spaces.
- Home and Community-Based Services
Home- and Community-Based Services allow individuals with special medical or developmental needs to live in the least restrictive setting while receiving the medical care and supports they need.
Program options
- Specialized Programs
If you do not qualify for any of the above Indiana Medicaid programs, you may qualify for one of the following specialized programs:
- Family planning eligibility program
- Emergency services only
- End-stage renal disease