Indiana Medicaid eligibility for most adults comes down to household income at or below 138% of the federal poverty level, which works out to roughly $22,026 a year for a single person in 2026.1IN.gov. Adult Income Chart Adults in that range enroll through the Healthy Indiana Plan (HIP). Older adults, people with disabilities, and applicants seeking long-term care face additional asset limits and a five-year lookback on transfers. Pregnant women and children qualify at higher income thresholds through separate programs.
Income Limits by Category
Indiana Medicaid is a set of programs, each with its own income ceiling tied to the federal poverty level (FPL). The broadest category covers adults aged 19 to 64 without a disability. They qualify through HIP at or below 138% FPL — $22,026 for a household of one in 2026.1IN.gov. Adult Income Chart
Pregnant women and children qualify at higher income levels through Hoosier Healthwise and related programs. Aged, blind, and disabled applicants use a different track with an asset test, covered below. Long-term care Medicaid, which pays for nursing homes and home-based waiver services, has its own income cap and transfer rules.
Residency and Citizenship
You have to live in Indiana and be a U.S. citizen, a lawful permanent resident, or another qualified non-citizen. Most lawful permanent residents wait five years after obtaining status before they can enroll. Refugees, asylees, trafficking victims, and certain veterans and military family members are exempt from that wait.2Medicaid.gov. Overview of Eligibility for Non-Citizens in Medicaid and CHIP A utility bill, lease, or state ID is enough to show residency.
How the Healthy Indiana Plan Works
HIP is the primary Medicaid program for non-disabled Indiana adults, and it does not work like traditional Medicaid. Every HIP member gets a Personal Wellness and Responsibility (POWER) Account and must contribute to it each month. Contributions run from $1 to $20 based on household income relative to the poverty level.3IN.gov. HIP – POWER Accounts Tobacco users pay a surcharge of up to 50%.
Members who pay their contributions get HIP Plus, which includes medical, dental, vision, and chiropractic services with no copays. The only additional cost is $8 for non-emergency use of the emergency room.3IN.gov. HIP – POWER Accounts
Missing payments has different consequences depending on income:
- Income above 100% FPL: coverage ends, and the member is removed from HIP.3IN.gov. HIP – POWER Accounts
- Income at or below 100% FPL: the member drops to HIP Basic. Basic still covers essential services but eliminates dental and vision, and adds copays of $4 to $8 per visit or prescription and up to $75 per hospital stay.4IN.gov. About the HIP Program
For most people, HIP Basic is a worse deal than paying the monthly contribution. Two doctor visits and two prescriptions can easily cost more in copays than a full year of POWER Account payments, and Basic members still lose dental and vision.
Asset Limits for Aged, Blind, and Disabled Applicants
Indiana’s Aged, Blind, and Disabled (ABD) category adds an asset test. Countable assets cannot exceed $2,000 for an individual or $3,000 for a married couple. Countable assets include bank balances, cash, stocks, bonds, and property other than your home. Your primary residence, one vehicle, and burial plots are exempt.5IN.gov. Indiana Medicaid – Eligibility Guide
Extra Rules for Long-Term Care
Long-term care Medicaid covers nursing home stays and home- and community-based waiver services. Applicants have to meet the ABD asset limits and clear several rules that don’t apply to other categories.
Five-Year Lookback on Transfers
Federal law imposes a 60-month lookback on asset transfers made before a long-term care Medicaid application.6Office of the Law Revision Counsel. 42 USC 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets Assets given away or sold below fair market value during that window trigger a penalty period during which Medicaid will not pay. The penalty is calculated by dividing the uncompensated transfer amount by the state’s average daily cost of nursing home care. A $60,000 gift at a $300 daily rate produces roughly a 200-day penalty. The clock starts only after the applicant is in a facility and otherwise eligible, so a poorly timed gift can leave someone with a nursing home bill and no coverage.
Income Cap and Miller Trusts
Indiana is an income-cap state for long-term care. If your monthly income exceeds 300% of the federal Supplemental Security Income (SSI) benefit, you do not qualify no matter how large your medical bills are. In 2026, SSI is $994 per month, putting the cap at $2,982.7Social Security Administration. SSI Federal Payment Amounts for 2026
A Qualified Income Trust, often called a Miller Trust, is the standard workaround. You deposit enough of your monthly income into the trust to bring what you actually receive under the cap, and Medicaid disregards the trust deposits. Only the applicant’s own income can go in. Depositing anyone else’s money, or other resources, turns the account into a countable asset and can disqualify you.8IN.gov. Instructional Packet for Establishing a Qualifying Income Trust (Miller Trust) After eligibility begins, the trustee pays for care from the trust and Medicaid covers the rest.
Spousal Protections
When one spouse enters a nursing home, federal rules protect the spouse who remains at home. In 2026, the community spouse can keep between $32,532 and $162,660 in countable assets depending on total couple resources, with a monthly income allowance between $2,643.75 and $4,066.50.9Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards If the community spouse’s own income falls below the minimum, a share of the institutionalized spouse’s income can be diverted to close the gap.
How to Apply
Applications run through the Indiana Family and Social Services Administration (FSSA). You can apply online through the FSSA Benefits Portal, by phone, in person at a Division of Family Resources office, or by mail.10IN.gov. Indiana Medicaid – Apply for Coverage Have proof of income, identity, and Indiana residency ready.
Federal rules require an eligibility decision within 45 days for most applications and within 90 days when eligibility is based on a disability.11eCFR. 42 CFR 435.912 – Timely Determination of Eligibility Missing a deadline to submit requested documents can delay or sink an application, so respond to FSSA requests quickly.
Once approved, you enroll with a managed care plan. HIP and Hoosier Healthwise members choose from Anthem, CareSource, or Managed Health Services. Hoosier Care Connect members choose Anthem or UnitedHealthcare.12IN.gov. Managed Care Health Plans The state assigns a plan if you don’t pick one.
Presumptive Eligibility
Some hospitals, clinics, and doctor’s offices in Indiana can grant temporary Medicaid on the spot. You answer a short set of questions about income and household size, and if you appear to qualify, you receive a letter with start and end dates while your full application is processed. Adults get HIP Basic-level benefits during presumptive coverage, meaning copays apply and dental and vision are excluded.13IN.gov. Presumptive Eligibility Pregnant women get prenatal visits, labs, and prescriptions but not labor and delivery under the temporary enrollment.
Retroactive Coverage
For most Indiana Medicaid categories, coverage can reach back up to three months before your application month if you would have qualified during that time.14IN.gov. FAQs – Retroactive Eligibility Under the A&D and TBI Waivers That matters when unpaid medical bills predate the application. HIP is the exception. Indiana’s HIP waiver eliminates retroactive coverage for adults who qualify through the expansion and some other traditional groups, including low-income parents. HIP coverage starts with the application month.
Renewing Coverage Each Year
Indiana Medicaid renews annually. The FSSA cross-checks tax and wage records first, and if the data confirms continued eligibility, coverage renews automatically. If more information is needed, a renewal notice goes out.
You have roughly 45 days from the notice to return updated income, household, and asset details.15IN.gov. Medicaid Redetermination FAQs Miss it and coverage ends. A 90-day reconsideration window then lets you submit the paperwork and get reinstated without starting over.16Medicaid.gov. Healthy Indiana Plan Section 1115 Medicaid Demonstration Fact Sheet
Let the 90 days lapse and, unless you qualify for a good-cause exception, you face up to six months locked out of the program before you can re-enroll.16Medicaid.gov. Healthy Indiana Plan Section 1115 Medicaid Demonstration Fact Sheet The lockout is specific to HIP and catches people who ignore the mail. Treat the renewal notice as urgent.
Appealing a Denial
If Indiana denies your application or ends your coverage, the notice will state the reason and explain how to appeal. You have 33 days from the date of the notice to file a written appeal.17IN.gov. Appeal Rights and Instructions Appeals can be mailed to the FSSA Document Center, faxed, hand-delivered to a local DFR office, or made by phone.18IN.gov. Medicaid Policy Manual Chapter 4200 – Appeals and Fair Hearings The 33 days are firm. A mailed appeal counts as received on the day it arrives, not the postmark date.
An Administrative Law Judge hears the case and issues a decision after reviewing evidence from both sides. You can bring documents and witnesses, and you can be represented, though representation is not required. If the ALJ rules against you, further appeals go to the FSSA Appeals Section and then to Indiana Superior Court. A successful appeal can restore benefits retroactively to the original application date.