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Learn About CHIP in Indiana

Indiana CHIP, known as Hoosier Healthwise within the state, is a health insurance program for children up to 19 years of age and pregnant women who would otherwise be uninsured and meet the program’s eligibility requirements. The CHIP insurance program provides comprehensive health insurance benefits at no to a low cost to eligible recipients. While this program does exist in every state within the U.S., however, it is worth knowing that every state has the ability to set its own costs, coverages and eligibility requirements within federal guidelines. Therefore, it is important to learn more about Hoosier Healthwise, even if you are familiar with other state programs.

This children’s health insurance program has eligibility requirements that must be met in order to receive coverage. These requirements include age, circumstance, residency and income requirements. The cost of the insurance plan is little to nothing as this is a low-cost health insurance plan intended to provide coverage to children and pregnant women that do not have a means of other forms of insurances.

What is CHIP in Indiana?

CHIP Medicaid, known as Hoosier Healthwise in Indiana, is a health care program that provides health insurance primarily to children, but also to pregnant women, who would otherwise remain uninsured and not have access to affordable healthcare. As an income-based program, eligibility and out of pocket costs will coincide with the amount of income that a family makes. However, while income limits do exist for this program, the limits are higher than that of the Medicaid benefits program.

This health insurance for kids and pregnant women program is nationally recognized and funded by both the federal government and the state of Indiana. Hoosier Healthwise has three different plans, however, the state will determine your eligibility for each plan and select the coverage that is right for you. These three plans are:

  • Package A. A full service plan available to low income children and pregnant women. Members of this plan do not incur any fees related to the health insurance.
  • Package C. Package C is a full service plan intended for children. There is a small monthly premium payment as well as small copayments for some medical services.
  • Presumptive Eligibility for Pregnant Women (PEPW). PEPW is a limited service plan available only to pregnant women. Coverage includes prenatal care during eligibility periods.

Who does Indiana CHIP cover?

If you are planning to submit a CHIP application, it is recommended that you familiarize yourself with the program’s eligibility requirements first in order to confirm whether or not you or your child may be eligible for coverage. To meet CHIP eligibility requirements, children must be younger than the age of 19 years. Children who are 18 years of age must still be living at home in order to qualify. Pregnant women may qualify, so long as other requirements have been met, regardless of age.

To apply for CHIP benefits in Indiana, you must be a resident of the state. Furthermore, to retain benefits once they have been granted, you must remain a resident. There are income limits for this program that are based upon household size. While limits do exist, these limits are higher than that of traditional Medicaid. It is also worth knowing that limits can change each year in Indiana as the limits are determined by the current year’s federal poverty line.

How to Apply for CHIP in Indiana

To obtain CHIP coverage in Indiana, you will need to submit an application either online, by phone or in person at your local office. When considering your application method, it is worth knowing that an online application is generally considered the fastest and most convenient method as you can complete the application on your own time and from the comfort of your own home.

No matter how you submit your CHIP application, your local office will attempt to verify your information, such as income. If this cannot be done electronically, your local office will request additional documents from you, such as proof of income. It is very important that you comply with these requests as quickly as possible as your application will not be processed until you do so.

What is included with Indiana CHIP coverage?

Indiana CHIP coverage is comprehensive as the program provides a great deal of coverage related benefits to children and pregnant women who qualify. While CHIP does exist within every U.S. state, as mentioned previously, each state determines certain conditions of the program’s eligibility, costs and coverage for that particular state. However, states must still follow basic coverage benefits for CHIP as determined by federal regulations. In Indiana, qualifying members can receive coverage including, but not limited to:

  • Visits with a doctor.
  • Preventative care.
  • Immunizations.
  • Lab and X-ray services.
  • Emergency services.
  • Mental health services.

How much is CHIP health insurance in Indiana?

In Indiana, CHIP insurance is provided at little to no cost, based upon family income. Your family income will have a large impact on the plan that the state provides to you. As mentioned previously, one of those plans (Package A) does not include fees. However, most plans will include small monthly premiums and copayments. Monthly premiums must be paid in order to avoid interruption or cancellation of coverage and copayments are generally due at the time of service. However, copayments are not charged for select services, such as immunizations and preventive care.

How long do CHIP benefits last in Indiana?

Indiana CHIP generally provides coverage to participants for a 12-month beneficiary period. However, there are some scenarios where coverage could end before the period is over. Such reasons can include the end of a pregnancy, if a child turns 19, if premiums remain unpaid or if the participant moves outside of Indiana.

Near the end of your CHIP insurance beneficiary period, you will receive a notice from your local office that will allow you to attempt to renew your coverage. Essentially, you will be completing a new application in order for your local office to determine whether or not you still qualify for benefits. If your child still qualifies, benefits can be extended for an additional 12 month period. However, plans may be changed due to changes in income or other eligibility requirements. To find out more about getting CHIP benefits, you can download our comprehensive CHIP guide today.