Starting in October 2013, Indiana Medicaid will begin using the Indiana Application for Health Coverage for all Indiana Medicaid programs, which can be completed through the Internet, by mail, or over the telephone. However, the Healthy Indiana Plan (“HIP”) will not use this new health coverage application, and instead will continue using the separate, unique HIP application. Applications for food stamps (“SNAP”) and cash assistance (“TANF”) will also be separate from applications for health coverage.
Effective
January 1, 2014, OMPP revised the aid categories for children, the overall aid
categories, and the eligibility criteria, all which are summarized here. Beginning January 1, 2014, Indiana Medicaid
is required to use the Modified Adjusted Gross Income (“MAGI”) method to
determine income eligibility. However,
Indiana has chosen to begin applying this new methodology to applications
received in October, and individuals submitting applications before January 1,
2014, will have their income eligibility calculated using both the current
income determination rules and the new MAGI rules. If the individual is eligible based on the
current income determination rules, the individual will be enrolled upon
determination. If the individual is
eligible based on the new MAGI rules, the individual will be enrolled effective
January 1, 2014. For individuals that
are currently Indiana Medicaid members, the MAGI rules will be applied at the
member’s annual redetermination. This
MAGI method will be used to determine income eligibility for the following aid
categories: (i) Ages 0 to 1; (ii) Ages 1 to 5; (iii) Ages 6 to 18; (iv) MCHIP;
(v) SCHIP; (vi) Former Foster Children, (vii) Parents/Caretakers; (viii)
Pregnancy; (ix) HIP; (x) Family Planning Eligibility Program; and (xi)
Inpatient Psychiatric Facility. All
other aid categories will continue to use the current, non-MAGI eligibility
rules. The key aspect of MAGI is that it
counts all taxable income for determining Medicaid eligibility, and asset or
resource tests are no longer considered.
OMPP
is also announcing, as recently approved by the Centers for Medicare and
Medicaid Services, that effective January 1, 2014, the income eligibility
threshold for HIP will be reduced from 200% of the federal poverty limit
(“FPL”) to 100% FPL. Individuals with
income above 100% FPL may seek coverage through the Health Insurance
Marketplace, and may be eligible for subsidies, such as a tax credit or cost
sharing reduction.
Also
effective January 1, 2014, Indiana Medicaid will implement a Hospital
Presumptive Eligibility (HPE) program that will allow acute-care hospitals to
enroll with Indiana Medicaid as Qualified Providers (“QPs”). QPs are authorized to enroll qualified
individuals into presumptively eligible aid categories, such as: (i) Children;
(ii) Parents/Caretakers; (iii) Family Planning; (iv) Former Foster Care
Children; and (v) Pregnant Women.
Other
changes effective January 1, 2014 are that: (1) Hoosier Healthwise Package B
(Pregnancy Coverage) will be used only for the Hospital Presumptive Eligibility
(HPE) program; and (2) individuals eligible for aid category MA 14: Former
Foster Children will no longer be enrolled in Care Select, but rather will be eligible for Hoosier Healthwise
Package A.
For
questions regarding Medicaid eligibility please contact Kristen Gentry at kgentry@kdlegal.com
or Meghan McNab at mmcnab@kdlegal.com.