Indiana Medicaid Office

Indiana Medicaid office (FSSA)

Indiana Medicaid is run by the Family and Social Services Administration (FSSA) and operates as four named programs rather than one umbrella plan: Healthy Indiana Plan (HIP) for expansion adults, Hoosier Healthwise for children and pregnant individuals, Hoosier Care Connect for aged, blind, or disabled members not in long-term care, and Indiana PathWays for Aging for members age 60 and over with long-term care needs. Most contact questions go directly to your managed care entity (MCE) — your plan, not the agency.

Where to call depends on whether you have a plan

Members not enrolled in a health plan (Traditional Medicaid) call FSSA directly:

• Traditional Medicaid Member Services — 800-457-4584
• Pharmacy Services — 855-577-6317

Members enrolled in a managed care plan call their plan's member services line. Indiana contracts with four MCEs as of the start of 2026 — Anthem, CareSource, MHS, and UnitedHealthcare — plus Humana for PathWays for Aging specifically. MDwise stopped offering Medicaid coverage on December 31, 2025; affected members were reassigned and can confirm their new plan through FSSA.

Enrollment broker (Maximus) — for choosing or changing a plan

• HIP — 877-438-4479
• Hoosier Care Connect — 866-963-7383
• Hoosier Healthwise — 800-889-9949
• Indiana PathWays for Aging — 877-284-9294

To report suspected fraud, call FSSA at 1-800-403-0864. Address, income, and household-change reports route through the FSSA Benefits Portal or your local Division of Family Resources (DFR) office rather than the central FSSA office.

Who qualifies for Indiana Medicaid?

The FSSA Eligibility Guide routes applicants into one of four major programs by population, not by a single income threshold. Each program has its own income test and, for older adults and people with disabilities, an asset test. Pregnant individuals and children typically land in Hoosier Healthwise. Working-age adults who aren't disabled or institutionalized land in the Healthy Indiana Plan (HIP). Aged, blind, or disabled members land in Traditional Medicaid, Hoosier Care Connect, or Indiana PathWays for Aging (the latter for members 60 and older with long-term-care needs).

Coverage categories

• Pregnant individuals — Hoosier Healthwise. Family size counts the unborn child; Presumptive Eligibility for Pregnant Women can provide immediate care while the full application is processed.
• Children through age 18 — Hoosier Healthwise. Some income brackets carry a monthly premium under the Hoosier Healthwise Package C and M.E.D. Works premium schedule.
• Adults age 19 and older (not disabled, not institutionalized) — Healthy Indiana Plan. HIP Plus members make a monthly contribution of 2% of family income to receive the enhanced benefit package, including vision and dental; HIP Basic has no contribution but fewer benefits.
• Aged, blind, and disabled members — Traditional Medicaid, Hoosier Care Connect, or Indiana PathWays for Aging. Disability must meet the Social Security Administration definition. Asset test applies (see income limits).
• Working disabled individuals — may qualify for MEDWorks with slightly higher income and a monthly premium.
• Institutionalized or HCBS waiver members — may qualify with income up to $2,982 per month, counted on the individual only (spousal income disregarded). Depending on countable income, may owe a monthly patient or waiver liability.

Home- and Community-Based Services (HCBS) waivers

HCBS waivers allow individuals with special medical or developmental needs to live in the least restrictive setting while receiving care. Indiana publishes these waiver programs:

• Adult Mental Health and Habilitation
• Behavioral and Primary Healthcare Coordination
• Child Mental Health Wraparound
• Community Integration and Habilitation (CIH) waiver
• Family Supports waiver
• Health and Wellness waiver (formerly the Aged and Disabled waiver)
• Indiana PathWays for Aging waiver (formerly the Aged and Disabled waiver)
• Traumatic Brain Injury waiver

Specialized programs for applicants who don't qualify above

FSSA also publishes two narrower benefit categories: the Family Planning Eligibility Program, and Emergency Services Only coverage for individuals who would otherwise qualify but lack the required immigration status.

Renewals run every 12 months

FSSA renews coverage annually. The state first attempts an electronic (ex parte) renewal using federal and state data. When that confirms eligibility, the household keeps coverage without paperwork. When data does not match, the household receives a pre-populated renewal packet and must respond by the printed deadline or coverage ends.

Indiana Medicaid income and asset limits (effective March 1, 2026)

FSSA publishes monthly income limits separately for each Medicaid program. The figures below are the standards effective March 1, 2026, as published on the Eligibility Guide. The federal poverty figures update every January, so these numbers shift each year — verify the current chart with FSSA before relying on a specific amount.

Pregnant individuals (Hoosier Healthwise)

Family size counts the unborn child. Apply for Presumptive Eligibility for Pregnant Women to receive immediate care while the full application is processed.

Children through age 18 (Hoosier Healthwise)

Some income brackets carry a monthly premium under Hoosier Healthwise Package C and M.E.D. Works.

Adults age 19 and older (Healthy Indiana Plan)

HIP Plus requires a monthly contribution of 2% of family income for enhanced benefits including vision and dental. HIP Basic has no contribution but a narrower benefit package.

Aged, blind, and disabled

Institutionalized members and those eligible for HCBS waiver services may qualify with monthly income up to $2,982. That income standard counts only the individual; the spouse's and other household members' income is disregarded. Depending on countable income, the member may owe a monthly patient or waiver liability.

Asset test (aged, blind, and disabled)

• Limit — $2,000 (single) or $3,000 (married)
• Counted — bank balances, cash on hand, stocks and bonds, property other than the family home
• Not counted — one vehicle, the home you live in, burial spaces

How to apply for Indiana Medicaid

The Indiana Application for Health Coverage is processed by the FSSA Division of Family Resources (DFR). One application screens for every Indiana Medicaid program — HIP, Hoosier Healthwise, Hoosier Care Connect, Indiana PathWays for Aging, and Traditional Medicaid. Once you submit a complete application with all required documentation, DFR has up to 90 days to decide.

Apply online: FSSA Benefits Portal

Go to fssabenefits.in.gov and click Apply Now next to Apply Online for Health Coverage. The portal handles applications, document uploads, case-status checks, and renewals. You can also apply through the federal Health Insurance Marketplace at healthcare.gov.

Apply in person at a DFR office

DFR operates a county-by-county office network. Use FSSA's Find My Local DFR Office tool to find the office for your county of residence and submit the application there.

Apply by phone

Call DFR at 1-800-403-0864 to start an application or to check the status of one already submitted. You will need your case number to check status.

Apply by mail

Complete the paper Indiana Application for Health Coverage and mail it to your local DFR office, or drop it off at any office. The same form is used for online, in-person, and mail applications.

Free help from a certified navigator

FSSA's Find a Navigator tool locates a trained certified navigator who can walk you through the application at no cost. Navigators are independent — they don't work for FSSA or any specific health plan.

Presumptive Eligibility for Pregnant Women

Pregnant applicants can receive immediate medical attention by applying for Presumptive Eligibility while waiting for the full application to process. Qualified providers (hospitals, FQHCs) make the PE determination on the spot.

Sharing case information with someone you trust

DFR will not share case information without a signed Authorization for Disclosure of Personal and Health Information form. The form can be submitted through the Benefits Portal, by fax, by mail, or in person at the local DFR office.

Federal decision timelines

Federal rules give states up to 45 days to decide most Medicaid applications and up to 90 days when the basis is disability — Indiana publishes the 90-day window as its standard processing time. Coverage can be retroactive up to three months before the application month for qualifying medical bills.

What Indiana Medicaid covers

Over two million Hoosiers carry coverage through Indiana Medicaid, and FSSA's provider network is more than 50,000 strong. What that coverage looks like depends on which of the four programs you're enrolled in — the benefits package and the managed care plan options differ across HIP, Hoosier Healthwise, Hoosier Care Connect, and Indiana PathWays for Aging.

The four Indiana Medicaid programs

• Healthy Indiana Plan (HIP) — for adults age 19 and older. Two benefit tiers: HIP Plus (broader benefits including vision and dental, with a monthly 2% POWER-style contribution) and HIP Basic (narrower benefits, no contribution).
• Hoosier Healthwise — for children through age 18 and pregnant individuals.
• Hoosier Care Connect — for aged, blind, or disabled members who are not in long-term care.
• Indiana PathWays for Aging — for members 60 and older with long-term care needs (the LTSS-integrated managed care program).

Managed care plans (MCEs) — as of 2026

FSSA contracts with four statewide MCEs for HIP, Hoosier Healthwise, and Hoosier Care Connect:

• Anthem Blue Cross and Blue Shield
• CareSource
• MHS (Managed Health Services)
• UnitedHealthcare Community Plan

Indiana PathWays for Aging adds Humana to the MCE roster alongside Anthem and UnitedHealthcare. MDwise stopped offering Medicaid coverage on December 31, 2025.

Help choosing a plan: Maximus enrollment broker

Indiana's enrollment broker (Maximus) helps members pick or change a plan. Different phone numbers route to different programs:

• HIP — 877-438-4479
• Hoosier Healthwise — 800-889-9949
• Hoosier Care Connect — 866-963-7383
• Indiana PathWays for Aging — 877-284-9294

General questions

For general questions about Indiana Medicaid benefits not tied to a specific plan, call the FSSA Member Services line at 1-800-457-4584. For questions about a plan-specific benefit, network, or prior authorization, call the member services line for your MCE.

Long-term services and supports

Long-term care for Indiana's aging population runs through Indiana PathWays for Aging, the state's integrated managed long-term care program for members 60 and older. HCBS waivers (Community Integration and Habilitation, Family Supports, Traumatic Brain Injury, Health and Wellness, and others listed under the Eligibility Guide) allow people with disabilities to receive supports in their own homes rather than in institutions.

Other state Medicaid pages