Indiana provides Medicaid coverage to eligible residents through several programs managed by the Indiana Family and Social Services Administration (FSSA). Whether you are an adult, a parent, pregnant, or caring for children, understanding the eligibility requirements can help you access affordable health coverage in 2026. This guide covers everything you need to know about qualifying for Indiana Medicaid, including income limits, program options, and how to apply.
Not sure if you qualify? Check your eligibility in minutes with our free screening tool.
Indiana Medicaid Programs Overview
Indiana expanded Medicaid under the Affordable Care Act through its unique Healthy Indiana Plan (HIP). The state offers several Medicaid programs tailored to different groups:
- Healthy Indiana Plan (HIP): Covers adults ages 19 to 64 who are not disabled or institutionalized. HIP uses a consumer-driven model with a personal health savings account called a POWER Account.
- Hoosier Healthwise: Covers children through age 18 and pregnant individuals. This is Indiana's combined Medicaid and CHIP program.
- Hoosier Care Connect: Serves individuals who are aged, blind, or disabled.
- Indiana PathWays for Aging: Covers individuals age 60 and older who need long-term services and supports.
- Traditional Medicaid: Covers certain aged, blind, and disabled individuals, including those in institutional settings.
For a full overview of benefits available in the state, visit our Indiana Benefits Overview.
2026 Income Limits by Category
Indiana Medicaid eligibility is based primarily on household income measured against the Federal Poverty Level (FPL). The 2026 FPL for a single individual in the 48 contiguous states is $15,960 per year. However, Indiana's current Medicaid income limits are based on figures effective March 1, 2025, and will update when the state adopts the new 2026 FPL guidelines (typically in spring 2026).
Adults (Healthy Indiana Plan)
Adults ages 19 to 64 qualify for HIP with incomes up to 138% of the FPL. The current monthly income limits are:
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,800 |
| 2 | $2,433 |
| 3 | $3,065 |
| 4 | $3,698 |
| 5 | $4,330 |
These figures are based on income before taxes, not take-home pay. There is no asset test for HIP.
When Indiana adopts the 2026 FPL, the income limit for a single adult is expected to increase to approximately $1,835 per month ($22,025 per year).
Children (Hoosier Healthwise)
Children through age 18 qualify for coverage with higher income limits than adults:
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $3,326 |
| 2 | $4,495 |
| 3 | $5,664 |
| 4 | $6,832 |
| 5 | $8,001 |
Children's coverage in Indiana extends to approximately 255% of the FPL, making it one of the more generous children's Medicaid programs in the country. Families with slightly higher incomes may need to pay a small monthly premium.
Pregnant Individuals
Pregnant individuals qualify for Hoosier Healthwise with income limits up to approximately 208% of the FPL:
| Household Size | Monthly Income Limit |
|---|---|
| 2 | $3,754 |
| 3 | $4,731 |
| 4 | $5,707 |
| 5 | $6,683 |
Family size for pregnant individuals includes the unborn child or children. Pregnant women can also apply for Presumptive Eligibility, which provides immediate temporary coverage while their full Medicaid application is processed.
Aged, Blind, and Disabled
Individuals who are aged (65 and older), blind, or disabled have separate income and asset requirements:
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,304 |
| 2 | $1,763 |
| 3 | $2,221 |
| 4 | $2,679 |
| 5 | $3,138 |
Asset limits also apply:
- Single individual: $2,000
- Married couple: $3,000
Disability must meet the Social Security Administration's definition. Certain assets like your primary home and one vehicle are typically exempt from counting.
HIP Plus vs. HIP Basic
The Healthy Indiana Plan has two benefit levels:
HIP Plus provides comprehensive benefits similar to commercial health insurance, including vision and dental coverage. To receive HIP Plus, members contribute 2% of their household income monthly to a POWER Account. This contribution is required regardless of income level.
HIP Basic is available to members with incomes below 100% of the FPL who choose not to make their POWER Account contribution. HIP Basic provides fewer benefits than HIP Plus and includes copayments for some services.
Members with incomes above 100% FPL must make their POWER Account contributions or risk losing coverage.
How to Apply for Indiana Medicaid: Step by Step
Applying for Indiana Medicaid is straightforward. Follow these steps:
Step 1: Gather Your Documents
Before starting your application, collect the following:
- Social Security numbers for all household members
- Proof of income (pay stubs, tax returns, or employer statements)
- Proof of Indiana residency (utility bill, lease, or mail with your address)
- Proof of U.S. citizenship or immigration status
- Information about any current health insurance
Step 2: Choose Your Application Method
You can apply through any of these options:
- Online: Visit the FSSA Benefits Portal to submit your application electronically. This is the fastest method.
- By Phone: Call FSSA Customer Service at 1-800-403-0864 (Monday through Friday, 8 AM to 4:30 PM Eastern Time).
- In Person: Visit your local Division of Family Resources (DFR) office.
- By Mail: Download an application from the FSSA website and mail it to your local DFR office.
Step 3: Complete the Application
Fill out all required sections of the application completely. Include information about everyone in your household, even if they are not applying for coverage. Household composition affects income calculations.
Step 4: Submit Required Documentation
Upload or bring copies of your supporting documents. Do not send originals. If you apply online, you can upload documents directly through the FSSA Benefits Portal.
Step 5: Wait for a Decision
Indiana aims to process Medicaid applications within 45 days (90 days for disability-related applications). You will receive a notice by mail informing you of the decision. If approved, your coverage start date depends on when you applied and your eligibility category.
Step 6: Choose a Health Plan
Once approved, you will need to select a managed care plan. Indiana's Medicaid managed care organizations include Anthem, CareSource, MDwise, MHS, and United Healthcare. If you do not choose a plan within the required timeframe, one will be assigned to you.
What Indiana Medicaid Covers
Indiana Medicaid, particularly through HIP Plus, covers a wide range of services:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance use disorder treatment
- Preventive care and wellness visits
- Lab work and diagnostic tests
- Emergency room services
- Maternity and newborn care
- Vision and dental services (HIP Plus)
HIP Basic covers most of the same services but does not include vision or dental coverage.
Special Eligibility Situations
Job Loss or Income Change: If you recently lost your job or had a significant income change, you may now qualify for Medicaid even if you did not before. Apply as soon as possible since coverage can be backdated up to three months.
Turning 19: Young adults turning 19 transition from Hoosier Healthwise to HIP. Income is re-evaluated based on adult standards. If your income exceeds HIP limits, you may qualify for subsidized Marketplace insurance.
New Baby: Adding a newborn to your existing Medicaid coverage is typically automatic if the mother was covered at the time of birth. Notify FSSA within 30 days.
Medicare and Medicaid Dual Eligibility: Some individuals qualify for both Medicare and Medicaid. Dual-eligible individuals may receive help with Medicare premiums, deductibles, and copayments through programs like the Medicare Savings Program or Qualified Medicare Beneficiary (QMB) program.
Frequently Asked Questions
How long does it take to get approved for Indiana Medicaid?
Most applications are processed within 45 days. Applications involving a disability determination may take up to 90 days. You can check your application status online through the FSSA Benefits Portal or by calling 1-800-403-0864.
Can I apply for Indiana Medicaid if I am undocumented?
Undocumented immigrants are generally not eligible for full Medicaid coverage. However, emergency Medicaid may cover emergency medical conditions regardless of immigration status. Pregnant individuals may qualify for coverage regardless of immigration status in some cases.
Do I have to pay anything with the Healthy Indiana Plan?
Yes. HIP requires monthly contributions of 2% of household income to your POWER Account. For HIP Plus members, these contributions unlock the full benefit package including dental and vision. If your income is below 100% FPL and you choose not to contribute, you receive HIP Basic with reduced benefits.
What happens if my income changes after I am approved?
You must report income changes to FSSA within 10 days. If your income increases above Medicaid limits, you may transition to subsidized Marketplace coverage. If your income decreases, you may qualify for additional benefits.
Can I apply for Medicaid and other benefits at the same time?
Yes. The FSSA Benefits Portal allows you to apply for Medicaid, SNAP (food assistance), and TANF (cash assistance) through a single application. Use our free screener to see all the programs you may qualify for at once.
Is there an asset limit for Indiana Medicaid?
For adults and children covered through HIP and Hoosier Healthwise, there is no asset test. Asset limits of $2,000 (single) or $3,000 (married) apply only to individuals in the aged, blind, and disabled category.
When do the 2026 income limits take effect?
The federal poverty guidelines for 2026 were published in January 2026. Indiana typically updates its Medicaid income standards in March or April based on the new FPL. Until then, the current income limits (effective March 1, 2025) remain in place. Check with FSSA or use our screener for the most current figures.
Next Steps
If you think you or your family members might qualify for Indiana Medicaid, do not wait to apply. Coverage can be backdated, and applying sooner means you start receiving benefits sooner.
- Check your eligibility now with our free screener
- Visit the FSSA Benefits Portal to apply online
- Call 1-800-403-0864 for assistance
- Visit our Indiana Benefits Overview to explore all available programs
Indiana Medicaid and the Healthy Indiana Plan provide essential health coverage to hundreds of thousands of Hoosiers. Whether you need coverage for yourself, your children, or an aging family member, understanding your eligibility is the first step toward accessing the care you need.
