The state of Indiana has many health insurance programs which Hoosiers may be eligible for that give essential healthcare benefits.
-All require you to be income eligible for the plan type
-All require you to live in Indiana
Healthy Indiana Plan - 19-64 adults
Hoosier Healthwise / CHIP - 0-18 children and pregnant women not eligible for HIP
Traditional Medicaid - disabled youth and adults who meet resource and income guidelines or have waiver benefits
Hoosier Care Connect - Medicaid recipients who need managed care benefits
Medicaid ER Benefits - those who would be eligible for HIP but are not citizens or have not lived here for over 5 years as permanent legal resident
Medicare Savings Programs - help for Medicare recipients with premiums and costs who meet the income and resource guidelines
To talk to a live person with the FSSA, call 1-800-403-0864, option 1, option 7, enter the zip code, and press 1 to confirm. Hold times can range and it closes at 4:30pm eastern time.
You must be an authorized representative or with the client. You must have the Social Security Number or Case Number to talk to a FSSA representative about the case. (Not the RID number).
Case Number: The Case Number for the whole household of the case at the FSSA office. It is a shared. It will begin with a 6, be 10 digits long and be on the communications from the FSSA. Old case numbers from before 2020 began with a 1 and are no longer in use. Sometimes this can change if somebody moves.
Application Number: This is given at the end of the application and can be used with the FSSA to look up a person if they have not yet been assigned a case number. After a case number is given, the application number is no longer relevant.
RID Number: The registered ID number is the number with the Medicaid Office. The number should start with 1, be 12 digits long and be on the Indiana Medicaid agency portal or the insurance card. Your RID number should not change and will be yours for life. The FSSA will not know this number or be able to look you up by it; it can also be referred to as your Medicaid ID. If a person has never had state coverage or a pending application, the RID of a Presumptive Eligibility may start with a 6 and be converted after an application is processed.
Some Important Terms:
FSSA: Family & Social Services Administration is the Indiana state agency responsible for healthcare, food (SNAP) and wage assistance (TANF).
MCE: Managed Care Entity (MCE) is your insurance company who has a contract with the state of Indiana to provide your insurance benefits directly to you.
-The Healthy Indiana Plan and Hoosier Healthwise have four MCEs: Anthem, CareSource, Managed Health Services and MDWise.
--- HIP members can change their plan only from November 1-December15th each year for the next calendar year. Flyer with more information.
-Hoosier Care Connect which gives managed care benefits to Medicaid recipients has three: Anthem, Managed Health Services & United HealthCare.
-Mediciad recipients, or fee for service Medicaid, do not have a MCE. The state is the provider of coverage.
Presumptive Eligibility: Temporary insurance granted to you because the navigator or agency staff presumes you are eligible based upon the true information you have provided. It is active for the month you apply and one extra month to give you time to apply for the full insurance. If an application is submitted it will last until you are approved or denied.
Authorized Representative: A person or company you have designated as somebody who can speak for you to the FSSA and will receive copies of your mail from the state. Always keep your authorized representative or navigator updated on your contact phone number, address and household changes.
Case Status Release: A form allowing the designated person or company to add the client to their online client list. Companies must be registered to do so. Allows the company to see the entire case for the household including documents due, appointments and documents received and download fax cover sheet to turn in solicited items. Case Numbers can change if you move or have a your former case officially closed.
Redetermination: This happens annually for each applicant. They will receive paperwork asking if anything in the household has changed. If so, they will return the paperwork with the proof of changes. Sometimes the FSSA will run verifications and find items they need the client to confirm.
Please keep the FSSA updated of any phone or address changes immediately so they receive all communications and do not miss redetermination paperwork. Call the FSSA at 800-403-0864 opt 1, opt 7, enter their zip code and hit 1 to confirm and talk to a live person. You will need to have the Case or Social Security number to do so.
Power Account Contributions: A monthly fee paid to your insurance company based upon your income for Healthy Indiana Plan. Is required to get PLUS benefits from the HIP and not fall into Basic coverage. Due to the pandemic, PAC payments are currently paused.
Gateway to Work: This program is currently suspended.
Have more questions? Ask a Navigator?
Confused on who to call? Here is a chart.