MEDICAID

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Medicaid is a program that provides health coverage to some low-income Indiana residents. Hoosier Healthwise is the Medicaid managed care program that covers families with children and pregnant women if state and federal guidelines are met. The elderly, and people with disabilities can also enroll in Medicaid if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid. Non-citizens who do not have immigration documents cannot enroll in Medicaid, but may be covered if treated for an emergency condition.

· For certain categories of people, eligibility for Medicaid is based on the amount of your household income.

In Indiana you may be eligible for Hoosier Healthwise if you are a child, a pregnant woman, or a parent of a child and your family income meets the Medicaid income standards.

Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so you should contact the Indiana Family and Social Services Administration for more information.

Low income persons eligible for Medicaid in Indiana*

Category                 Income eligibility (as percent of federal poverty level)

Child 0-1                             200%
Child 1-19                           150%
Non-working parents              20%
Working parents                    26%
Pregnant woman                   200%

* Eligibility information was compiled from State Health Facts Online, the Kaiser Family Foundation, and may have changed since this guide was published. Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level*, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2009:

Size of Family Unit                  Poverty Guideline (annual income)

     1                                                 $ 10,830
     2                                                 $ 14,570
     3                                                 $ 18,310

For larger families add $3,740 for each additional person.

So, for example, using this guideline, 200% of the federal poverty level for a family of 3 would be an annual income of $36,620, or a monthly income of $3,052.

* Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

· Families who get cash benefits from TANF (Temporary Assistance for Needy Families) are probably also eligible for Hoosier Healthwise.

Parents should know that when you get a job, you may qualify for transitional coverage under Hoosier Healthwise for a 12-month period.

· Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits are eligible for Medicaid.

Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage under a different eligibility category that may require payment of a premium.

· Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, Medicaid may be able to help you with your Medicare expenses.

If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance. This is called the Qualified Medicare Beneficiary (QMB) program.

If your household income is below 120% of the poverty level, Medicaid will pay for your monthly Medicare Part B premiums only. This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

Contact the Indiana Family and Social Services Administration for more information about other eligibility requirements.

· There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the Indiana Family and Social Services Administration.


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