Indiana Medicaid and HIP 2026: How to Apply

Indiana Medicaid and HIP are health coverage, not a cash grant, and applying is free. Our Indiana Medicaid income limits guide has the full chart for every household size.

Indiana Medicaid at a Glance (November 2026)

HIP covers roughly 460,000 Hoosiers, per the October 8, 2026 letter from Governor Mike Braun submitting HIP 3.0. Here's how Indiana's coverage fits together, from FSSA and Indiana Medicaid pages checked November 13, 2026:

Who Qualifies for Indiana Medicaid and HIP in 2026

FSSA's HIP work requirement page describes the HIP group as adults 19 to 64 who aren't pregnant and aren't enrolled in or eligible for Medicare; the HIP page adds that they must meet the income line. Indiana Medicaid's member page sorts everyone else into 5 programs:

• Healthy Indiana Plan (HIP): adults; the member page also lists HIP under pregnant women.
• Hoosier Healthwise: children and pregnant women.
• Hoosier Care Connect: adults with disabilities and people who are aged, blind or disabled.
• Indiana PathWays for Aging: older Hoosiers in the aged, blind and disabled group.
• Traditional Medicaid: fee-for-service coverage for some children, adults and people who are aged, blind or disabled.

Pregnant women can start care before DFR finishes: the Indiana Medicaid apply page says pregnant women "may be able to receive medical care while you wait for your application to be processed" through presumptive eligibility. For how Indiana's limits compare with other states, see our national Medicaid income limits guide.

What HIP Covers: Health Plans, POWER Accounts and Copays

Indiana's HIP runs through 3 named health plans. FSSA's plan selection page says "four health plans" serve HIP members but names only Anthem, CareSource and MHS; FSSA announced on November 12, 2025 that MDwise would stop serving HIP and Hoosier Healthwise on January 1, 2026.

Source: FSSA How to Enroll in HIP (opens in a new tab) and Health Plan Selection (opens in a new tab), checked November 13, 2026.

Changing plans. Per the FSSA plan selection page, members change plans by calling 877-GET-HIP9 between November 1 and December 15, with the change taking effect January 1 for the next calendar year. That window is open now for 2027. New applicants who don't choose are assigned a plan, and an assignment lasts the calendar year even if you leave HIP and come back.

HIP Plus and HIP Basic. FSSA's POWER account page says HIP Plus includes vision, dental and chiropractic care, while HIP Basic doesn't cover those and charges copays for most doctor and hospital visits except preventive care and family planning. A non-emergency ER visit costs $8.

The POWER account conflict. FSSA's consumer pages still describe monthly POWER account contributions of $1 to $20 for one person, set by income, with members over poverty removed for not paying and members under poverty moved to HIP Basic. The enrollment page says HIP Plus coverage starts when your first contribution or Fast Track payment is processed. But Indiana's own October 2026 HIP 3.0 application says that after the June 2024 Rose v. Becerra ruling, HIP has continued "without POWER Account premiums or coverage consequences for nonpayment." Your best bet: if an invoice arrives, call 877-GET-HIP9 and ask what happens if you don't pay before you skip it or pay it.

What HIP 3.0 would change. Indiana asked CMS to begin HIP 3.0 on October 1, 2027, and to start copays sooner, "as soon as practicable," under Senate Enrolled Act 1, which took effect July 1, 2026. The application's proposed full copays include:

Source: Indiana HIP 3.0 waiver application (opens in a new tab), October 2026. Not approved as of November 13, 2026, per the pages Grantsights checked.

The application keeps total cost sharing under the federal 5% of family income cap and says that, under federal law, services from FQHCs, community mental health centers, certified community behavioral health clinics and rural health clinics aren't subject to copays.

How to Apply for Indiana Medicaid, Step by Step

Indiana runs 1 application through DFR whether you're applying for HIP, Hoosier Healthwise or coverage for a disabled parent.

Step 1: Pick how to apply

Step 2: Send everything at once

The Indiana Medicaid apply page says "all required documentation must be submitted before DFR can begin processing your application." For HIP, FSSA tells applicants to call 1-877-GET-HIP9 with questions about what to include. Have these ready:

• Pay stubs or employer statements for everyone in the tax household
• Social Security numbers and immigration papers for anyone applying
• Proof of pregnancy, if it applies
• For the 2027 work rule: proof of hours or an exemption for the 3 months before you apply

Step 3: Wait for DFR's letter

Indiana Medicaid says determining eligibility "can take up to 90 days" once the application is complete, while FSSA's HIP page says HIP applications are processed within 45 business days after all required information arrives. Federal rule 42 CFR 435.912 (opens in a new tab) sets 45 calendar days for most applications and 90 for disability-based ones. Check status on the portal or at 1-800-403-0864 with your case number.

Step 4: Pick a plan

If you didn't pick a plan on the application, one is assigned. You'll get an ID card from the plan.

For example, one applicant in Evansville, a 38-year-old part-time bookkeeper earning $1,500 a month with no job-based coverage, earns $18,000 a year, under HIP's $22,026 line. If she applies in January 2027, DFR would look at October through December 2026; at $1,500 a month her income is well over $580, which FSSA converts to more than 80 hours at $7.25, so she'd meet the rule (an illustration from FSSA's figures, not a real case).

Indiana's HIP Work Requirement (January 1, 2027)

The rule begins January 1, 2027 for new applicants and for redeterminations started on or after that date, per the FSSA HIP work requirements page. It follows the federal interim final rule that appeared in the Federal Register on June 3, 2026 (opens in a new tab). Members not yet up for redetermination aren't covered until their date comes.

What counts: 80 hours a month of work, school at least half time (college, high school or GED, in person or online), apprenticeships, work programs or community volunteering, in any mix. Or monthly income of at least $580. FSSA explains that $580 is $7.25 times 80, and it converts income to hours by dividing gross pay by $7.25. Paid time off counts.

Which months: new applicants are checked on the 3 months before they apply, so a January 2027 application looks at October, November and December 2026. Members enrolled before 2027 must show compliance in any 3 months since their last redetermination; FSSA's example is a March 2027 redetermination looking back to April 2026. FSSA says the state checks every 3 months and members renew HIP every 6 months.

Who's exempt (for any month with at least one qualifying day): former foster youth under 26; members of a federally recognized tribe; parents or caregivers of a child 13 or younger; veterans with a 100% disability rating; people pregnant or within 12 months of a pregnancy ending; people released from jail or prison within 90 days; people following SNAP or TANF work rules; people in drug or alcohol treatment; and people the state finds medically frail. FSSA says it's still working with CMS on medical frailty criteria.

How to report: the Benefits Portal (FSSA calls it "the easiest way"), DFR at 1-800-403-0864, mail to the FSSA Document Center, PO Box 1810, Marion, IN 46952, or a DFR office. Report changes in work, school, health or family within 10 days.

If you don't comply: coverage stops and you must reapply, and FSSA says you can't get Marketplace financial help during that time. Notices started going out July 1, 2026, and FSSA's pre-screening tool (opens in a new tab) shows whether you're likely exempt.

Indiana's 2025 and 2026 Laws: Enrollment Limits and Cost Sharing

Indiana passed 2 laws that shape HIP's future, and its October 2026 waiver application lays both out:

• Senate Enrolled Act 2 (2025) says HIP "is not an entitlement program," must run only through a Section 1115 waiver, and limits HIP enrollment based on state appropriations. The new Indiana Code 12-15-44.5-10(b) says the FSSA secretary "shall limit enrollment" so spending doesn't exceed state funding.
• Senate Enrolled Act 1 (2026), effective July 1, 2026, directs FSSA to add cost sharing for HIP within the federal 5% of income cap.

Is there an enrollment cap? Indiana's application says it "is not requesting approval of a fixed enrollment cap or a predetermined numerical limit." It asks CMS to confirm that if funding runs short, Indiana could end expansion coverage or seek an amendment to limit enrollment. Indiana law already ends HIP if the federal match drops below 90% and hospital assessment fees can't cover the gap. Grantsights didn't find an announced HIP enrollment freeze or waitlist on FSSA's pages on November 13, 2026.

Grantsights analysis of the HIP 3.0 application's public comment section shows enrollment limits drew pushback: several commenters asked FSSA to drop the enrollment cap and termination language, noting the application itself doesn't expect a cap to be needed, and FSSA kept the request in its final filing.

What FSSA Doesn't Tell You About Indiana Medicaid

FSSA spreads HIP information across a dozen pages, and 6 points are easy to miss:

1. The work rule already reaches into 2026. A January 2027 applicant is judged on October to December 2026, so hours you work this fall matter.
2. Plan switching closes December 15. Outside November 1 to December 15, you're generally locked into your HIP plan for the calendar year.
3. POWER account pages and the waiver disagree. One part of the state says nonpayment drops you; the state's own waiver filing says there are no consequences. Ask before acting.
4. Losing HIP for the work rule blocks Marketplace help too. FSSA says you can't get financial help on the Marketplace while you're out for noncompliance.
5. Decision times differ by page. Indiana Medicaid says up to 90 days; HIP says 45 business days. Both start only once DFR has everything.
6. Texts come from 43816. FSSA says its work rule texts come from that short code and don't ask about case information, so a text asking for your Social Security number is a red flag.

Common Mistakes and Red Flags

A common mistake is sending part of the paperwork. DFR doesn't start the clock until it has every required document, so a missing pay stub can add weeks.

Other mistakes that cost Indiana families coverage:

• Underestimating the 10-day reporting rule. New jobs, school changes and pregnancies must be reported within 10 days.
• Not claiming an exemption. Parents of a child 13 or younger and caregivers should make sure DFR knows before redetermination.
• Skipping Hoosier Healthwise for the kids. Children qualify at far higher incomes than HIP adults.
• Missing the 4:30 p.m. cutoff. Appeals must arrive by close of business on the 33rd day, and mailed appeals count from receipt, not postmark.

Red flags: Applying is free. Avoid anyone who charges to file or asks for a gift card. FSSA says it doesn't use AI to process applications, and its texts don't ask for case details.

If You're Denied or Lose Coverage

You have 33 days from the date of the notice or the adverse action, whichever is later, per the Indiana appeal rights notice. Mail, fax or hand-deliver a signed letter with your name, case number and reason, plus a copy of the notice, to the address printed on your notice.

• Keep coverage: if your appeal arrives before the change takes effect, you keep the same benefits while it's pending.
• Backdated coverage: federal law limits it, for applications from January 1, 2027, to 1 month for expansion adults and 2 months for others. Indiana's HIP 3.0 filing lists the "absence of retroactive coverage" among HIP's original features that the 2024 ruling put at risk, and FSSA's consumer pages don't spell out the current HIP rule, so ask DFR how far back your application can reach.
• Over the line: compare Marketplace plans on HealthCare.gov.

Other Help for Indiana Families

Medical bills are only part of what Indiana families juggle, and Hoosier households on Medicaid often qualify for food and utility help too:

• Food: the Indiana SNAP benefits guide and our Indiana food stamps guide.
• Pregnancy and young children: the Indiana WIC income limits guide and the national WIC guide.
• Utility bills: the Indiana LIHEAP guide.
• Housing: the rental assistance programs guide.

Grantsights' free eligibility checker points to other official programs in Indiana. It doesn't decide Medicaid eligibility; DFR does.

FAQ: Indiana Medicaid and HIP

How do I apply for Medicaid in Indiana?

On the FSSA Benefits Portal, by calling DFR at 1-800-403-0864, at a DFR office or on HealthCare.gov.

Who qualifies for the Healthy Indiana Plan in 2026?

Hoosiers 19 to 64 up to $22,026 a year alone, not pregnant and not on Medicare.

Does Indiana Medicaid have a work requirement?

For HIP from January 1, 2027: 80 hours a month or $580 in income, unless exempt.

Is there a cap on HIP enrollment?

No fixed cap, but SEA 2 ties HIP enrollment to state funding.

How long does Indiana take to decide a Medicaid application?

Up to 90 days once complete; HIP says 45 business days.

Do I have to pay a POWER account contribution for HIP?

FSSA pages list $1 to $20 a month, but the state's waiver filing says nonpayment has had no consequences since 2024; call 877-GET-HIP9.

How long do I have to appeal an Indiana Medicaid decision?

33 days from the notice or the action, whichever is later.

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Sources

1. FSSA: Healthy Indiana Plan (opens in a new tab), checked November 13, 2026
2. FSSA: How to Enroll in HIP (opens in a new tab), checked November 13, 2026
3. FSSA: HIP Health Plan Selection (opens in a new tab), checked November 13, 2026
4. FSSA: HIP POWER accounts (opens in a new tab), checked November 13, 2026
5. FSSA: HIP work requirements for members (opens in a new tab), checked November 13, 2026
6. Indiana Medicaid: Apply for Medicaid (opens in a new tab), checked November 13, 2026
7. Indiana Medicaid: Members (opens in a new tab), checked November 13, 2026
8. Indiana Medicaid: Appeal Rights and Instructions (opens in a new tab), checked November 13, 2026
9. Indiana HIP 3.0 waiver application on Medicaid.gov (opens in a new tab), October 2026
10. Medicaid.gov: Indiana's eligibility levels among all states (opens in a new tab), as of December 1, 2023
11. Federal Register: rule behind Indiana's 2027 requirement (opens in a new tab), June 3, 2026
12. FSSA: MDwise leaves HIP and Hoosier Healthwise (opens in a new tab), November 12, 2025
13. eCFR: 42 CFR 435.912 (opens in a new tab)