Medicaid Eligibility in Indiana: Income Limits & How to Apply

Medicaid Eligibility in Indiana

Indiana expanded its Medicaid program under the Affordable Care Act, opening Healthy Indiana Plan (HIP) to adults aged 19-64 whose income falls at or below 138% of the federal poverty level. In 2026, that works out to roughly $21,597 for one person or $44,367 for a family of four.

Under Indiana's expanded program, coverage extends to:

• Adults aged 19-64 with income up to 138% FPL
• Children in families with income up to 200-300% FPL (varies by age)
• Pregnant women with income up to 185-200% FPL
• Seniors and people with disabilities who meet income and asset requirements

About Healthy Indiana Plan (HIP)

If you're an Indiana resident trying to understand your healthcare options, you'll want to know about the Healthy Indiana Plan (HIP), which is the state's Medicaid program. It covers adults up to 138% of the Federal Poverty Level (FPL), and also extends to children, pregnant women, seniors, and individuals with disabilities. For a single person, this means an income limit of approximately $1,731 per month, or about $20,772 annually. A household of two would have an income limit of around $2,343 per month, or $28,116 annually. For a family of three, the limit is about $2,955 per month, or $35,460 annually, and for a family of four, it's roughly $3,567 per month, or $42,804 annually. As of 2024, approximately 1.88 million people, or 27.2% of Indiana's population, are enrolled in Medicaid or CHIP, demonstrating that this is a widely used and essential program.

If your income is close to the Medicaid cutoff, you might transition between HIP and marketplace coverage on HealthCare.gov. For example, if your income is just above the 138% FPL threshold, you'd likely qualify for significant subsidies on the marketplace. With Indiana's benchmark Silver plan at approximately $491 per month, subsidies could drastically reduce what you actually pay. It's important to remember that income changes can shift your eligibility, so it's crucial to report any household income fluctuations. If you lost coverage during recent Medicaid redeterminations, you can reapply at any time if your circumstances change and you believe you now qualify.

The Healthy Indiana Plan offers comprehensive benefits. For HIP Plus members, cost-sharing is managed through a "POWER Account Contribution," which is an affordable monthly payment based on your income, with no copayments for doctor visits, pharmacy services, or hospital admissions. Preventive care and maternity services are not subject to deductibles. HIP Plus generally includes vision and dental coverage. Indiana also offers several Home and Community-Based Services (HCBS) waivers, such as the Indiana PathWays for Aging Waiver for individuals 60 and older, the Health & Wellness Waiver for those under 60 needing nursing facility level of care, and waivers for individuals with traumatic brain injuries or intellectual/developmental disabilities. These waivers allow individuals to receive care in their homes or communities rather than institutions.

Be aware of potential processing delays when applying for or renewing Medicaid in Indiana. Some individuals have reported delays in redetermination processing due to a high volume of cases. You'll need to provide documentation like proof of identity, income (pay stubs, bank statements, tax returns), and residency (utility bill, lease agreement). For seniors, there's an asset limit of $2,000 for a single applicant and $3,000 for a married couple where both apply, though certain assets like your primary home and one vehicle are exempt. If you are currently an MDwise member, you will need to select a new managed care plan from Anthem, CareSource, or Managed Health Services, as MDwise is no longer available as of January 1, 2026. If you don't choose, you'll be automatically assigned a plan, but you'll have a 90-day window to switch if you're not satisfied. To take action, gather all your necessary documents and apply online through the Indiana Family and Social Services Administration portal or HealthCare.gov, or visit your local Division of Family Resources office if you encounter delays or need assistance.

Indiana Medicaid Income Limits 2026

The following table shows the key income thresholds for Indiana in 2026:

If your household income falls below the 138% FPL column, you qualify for Healthy Indiana Plan (HIP). If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.

The benchmark Silver plan in Indiana costs about $491/month before subsidies, which is in line with the national average. Subsidies can significantly reduce this cost for qualifying households.

Marketplace Insurance in Indiana

Indiana residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Indiana costs approximately $491/month for a 40-year-old in 2026.

Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Indiana might pay after subsidies:

These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.

Indiana uses the federal marketplace at HealthCare.gov for ACA enrollment. When you apply, the system automatically checks your Medicaid eligibility — if you qualify, your application is forwarded to the state Medicaid agency.

Indiana adopted Medicaid expansion, bringing Healthy Indiana Plan (HIP) coverage to low-income adults who previously had no affordable option. The transition between Medicaid and marketplace coverage is handled through HealthCare.gov.

How to Apply for Healthy Indiana Plan (HIP)

1. Online application — Start at HealthCare.gov. Your Medicaid eligibility is checked automatically when you enter your income details.
2. State Medicaid office — Apply directly through Indiana's Medicaid agency at any time during the year. Unlike marketplace insurance, Medicaid has no enrollment deadline.
3. Phone assistance — Call Indiana's Medicaid helpline for guided help completing your application.
4. In-person help — Visit your county human services office or a local navigator for face-to-face support.

To complete your application, you'll need income documentation (pay stubs, tax returns), a Indiana address for residency verification, Social Security numbers for household members, and information about existing coverage.

Frequently Asked Questions

Medicaid Eligibility in Nearby States