Medicaid FYI
Medicaid=73% Federal Money and 27% State Money.

The Process:
You complete and give your application to the Division of Family Resources... Now what? The
caseworker will collect all of the information and enter it into a program called ICES. (They have 30
days for TANF and Food Stamps, 45 days for Medicaid and 90 days for Medicaid Disability to tell you
if you are approved.) The program automatically determines what benefits you are able to receive
from the ones that you asked for. There are 34 DIFFERENT packages of Medicaid in Indiana! The
ICES system goes down the list to find which one the person is eligible. The list starts with the
"best" package and goes down to the most limited.

Disability Definition:
Many states use the Social Security Administration definition/eligibility for their Medicaid Disability
definition. Indiana has it's own definition:
  • Indiana Medicaid Definition of Disability-A physical or mental impairment, disease, or loss that
    is verifiable by a physician licensed under IC 25-22.5, that appears reasonably certain to result
    in death or to last for a continuous period of at least 12 months without significant
    improvement, and that substantially impairs the individuals ability to perform labor or services
    or to engage in a useful occupation; or A mental impairment, disease, or loss that is
    diagnosed by a physician licensed under IC 15-22.5 or a health services provider in
    psychology licensed under IC 25-33-1, and verifiable by a physician licensed under IC 25-22.5
    or a psychologist licensed under IC 25-33, and that appears reasonably certain to last for a
    continuous period of at least 12 months without significant improvement, and that
    substantially impairs the individual’s ability to perform labor or services or to engage in a
    useful occupation.

Important Things to Know:
  • Failure to receive medical evidence is not an acceptable reason for denial of an application if the
    disabled person is still interested in obtaining Medicaid coverage. As it is the joint responsibility
    of the applicant and the caseworker to make every effort to obtain the medical information,
    caseworkers must monitor a pending application closely for receipt of the medical information
  • Parent's income for youth under 18 years of age in institutional settings are not counted when
    they have established residence in a Medicaid approved hospital for at least 30 days and meet
    disability, income and resource guidelines. In other words, the youth will be considered a
    “family of one” and the parent’s income is not counted towards Medicaid eligibility.
  • If an error occurs with your benefits...the caseworker CAN correct the error by completing a
    "fiat" in the system. This may be because of a change in Medicaid category, change in food
    stamp benefits, not eligible for services that month for whatever reason... If your caseworker
    doesn't know how to do this, they can ask for help from one of their supervisors. If their
    supervisor doesn't know, then ask for their supervisor.


Indiana Names for Programs:
  • Hoosier Healthwise is a health insurance program for Indiana children, pregnant women, and
    low-income families. Health care is provided at little or no cost to Indiana families enrolled in
    the program. Contact 800-889-9949. Alternate names: Medicaid, Low-income Medicaid or
    Package A/B/C
  • Children’s Health Insurance Program (CHIP) is a part of Hoosier Healthwise. It expands
    coverage to children who are in low-income families, but do not qualify for Medicaid.
    Eligibility in CHIP varies based on the child’s age, but it covers children in families with
    incomes that range from 100 percent to 250 percent of the federal poverty level.
  • Medicaid Select is a health insurance program for Medicaid-eligible Hoosiers who are blind, aged
    and disabled. Contact 877-MED SELECT or 877-633-7353. Alternate names: Traditional
    Medicaid, Disability Medicaid, Care Select, Medicaid Disability.

Miscellaneous info: