Haris Ashley
If you are pregnant and looking to get medical insurance in Indiana, there are several options available to you. Firstly, you can explore Medicaid, a government-provided insurance that offers coverage to pregnant women through various programs such as Hoosier Healthwise, Healthy Indiana Plan, and Hoosier Care Connect. Each program has specific eligibility requirements, and you can apply by submitting a Medicaid application. Alternatively, you can consider private insurance plans offered through the Health Insurance Marketplace, which may provide essential health benefits and follow established limits on cost-sharing. It's important to note that being pregnant doesn't qualify you for a Special Enrollment Period, but the birth of your child does, allowing you to enroll in a Marketplace plan outside of the Open Enrollment Period.
| Characteristics | Values |
|---|---|
| Indiana Medicaid programs for pregnant women | Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, Traditional Medicaid |
| Hoosier Healthwise coverage | Doctor visits, prescription medicine, mental health care, dental care, hospitalizations, surgeries |
| Healthy Indiana Plan coverage | Dental, vision, chiropractic |
| Healthy Indiana Plan eligibility | Adults aged 19-64, not disabled, meet specific income levels |
| Hoosier Care Connect eligibility | Aged 65 and over, blind, disabled, not eligible for Medicare |
| Traditional Medicaid eligibility | Not enrolled in managed care |
| Medicaid eligibility factors | Income, family size, medical history, doctor's care plan |
| Medicaid application | Indiana Application for Health Coverage |
| Health Insurance Marketplace | Ambetter Health, plans must cover essential health benefits |
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What You'll Learn
Medicaid eligibility for pregnant women
Indiana Medicaid provides coverage to pregnant women through two programs. One of these programs is Hoosier Healthwise, a health care program that covers doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost. The other program is not explicitly named, but it is likely the Healthy Indiana Plan, which requires a minimal monthly contribution.
To apply for Medicaid, you will need to fill out and submit a Medicaid application, also known as an Indiana Application for Health Coverage. Medicaid eligibility is determined by several factors and can be complicated, so it is recommended to apply even if you are unsure whether you qualify.
If you already have Marketplace coverage when your baby is born, you can keep your current plan and add your baby to your coverage, or create a separate enrollment group for your baby and enroll them in any plan for the remainder of the year. If you report your pregnancy, you may be eligible for free or low-cost coverage through Medicaid or the Children's Health Insurance Program (CHIP). If you are deemed eligible for Medicaid or CHIP, your information will be sent to the state agency, and you will not be given the option to keep your Marketplace plan.
MHS Indiana also offers a special program called Start Smart for Your Baby (Start Smart) for women who are pregnant, particularly those who have previously had complicated pregnancies or delivered pre-term babies. Through this program, you will be matched with a Registered Nurse with high-risk obstetrical experience who can educate and support you throughout your pregnancy.
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Marketplace coverage options
If you are already enrolled in Marketplace coverage, you do not need to report your pregnancy to the Marketplace. You can keep your current plan and add your baby to your coverage after you give birth. Alternatively, you can create a separate enrollment group for your baby and enroll them in any plan for the remainder of the year.
If you do not have Marketplace coverage, you can apply for it during the Open Enrollment Period. Being pregnant does not qualify you for a Special Enrollment Period, but the birth of a child does. If you have had Medicaid or CHIP coverage that ended after you gave birth, you can apply for Marketplace coverage outside of the Open Enrollment Period.
Marketplace plans include the Health Insurance Marketplace's Ambetter Health, which offers affordable health care coverage for individuals and families. Depending on your family size and income, you may qualify for help to pay your monthly premium.
If you are pregnant and do not have insurance, you may be eligible for Medicaid or the Children's Health Insurance Program (CHIP). Medicaid provides coverage to pregnant women through several programs, including Hoosier Healthwise, which covers doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost. To apply for Medicaid, you will need to fill out and submit an Indiana Application for Health Coverage.
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The Healthy Indiana Plan
The HIP program includes a special savings account called a Personal Wellness and Responsibility (POWER) account. Every HIP member has their own POWER account, which is used to pay for the first $2,500 of medical expenses for covered services. The state pays most of the $2,500, and if you are in HIP Plus or HIP State Plan Plus, you are responsible for paying a portion. HIP Plus provides health coverage for a low, predictable monthly cost and includes benefits such as dental, vision, or chiropractic care. It is important to note that with HIP Plus, there are no copays when you visit the doctor, fill a prescription, or go to the hospital for an emergency.
To enrol in the Healthy Indiana Plan, you can apply online and make a Fast Track payment by credit card when completing the application. If you make a Fast Track payment and are deemed eligible for HIP, your HIP Plus coverage will begin on the first day of the month in which you submitted your application. If you do not apply online or choose not to make a Fast Track payment, you can still make a Fast Track payment while your application is being processed. You will receive an invoice from the Managed Care Entity (MCE) you selected for health coverage. It is important to note that once you have made your payment, you may not change your MCE/health plan, so be sure to choose the right one for your needs.
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Hoosier Healthwise
To be eligible for Hoosier Healthwise, families must have an income of up to 250% of the federal poverty level. Members requiring long-term care may qualify for hospice benefits under Traditional Medicaid. For more information about benefits, members can call CareSource Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711), Monday through Friday, 8 a.m. to 8 p.m. Eastern Time.
Pregnant women in Indiana can also explore other options for medical insurance. The Healthy Indiana Plan, for instance, is a health insurance program for adults ages 19 through 64 who are not disabled. This plan requires a minimal monthly contribution for coverage. Additionally, Medicaid provides coverage for pregnant women through two programs. To apply for Medicaid, individuals will need to fill out and submit a Medicaid application, also known as an Indiana Application for Health Coverage.
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Special Enrollment Period
In Indiana, pregnancy alone does not qualify someone for a Special Enrollment Period. However, the birth of a child does. This means that after giving birth, you can enroll in a Marketplace health plan even if it is outside the Open Enrollment Period.
If you already have Marketplace coverage when your baby is born, you can either keep your current plan and add your baby to your coverage or create a separate enrollment group for your baby and enroll them in any plan for the remainder of the year. You must report the birth to the Marketplace by updating your application as soon as possible.
If you are found eligible during your pregnancy, you will be covered for at least 60 days after you give birth, depending on your state. Some states offer coverage for a full 12 months after giving birth. When your state's coverage period ends, you may no longer qualify, and your state will notify you if this is the case. If your coverage ends, you can apply and enroll in a Marketplace plan.
If you have Medicaid when you give birth, your newborn is automatically enrolled in Medicaid coverage and will remain eligible for at least a year. Losing other coverage also qualifies you for a Special Enrollment Period.
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Frequently asked questions
The Healthy Indiana Plan is a health insurance program for qualified adults aged 19 to 64. It pays for medical costs for members and can include dental, vision, and chiropractic coverage.
To apply for Medicaid, fill out and submit the Indiana Application for Health Coverage. You can apply for Medicaid and CHIP coverage online.
Hoosier Healthwise is a health and medical coverage program for children up to age 19 and pregnant women in Indiana.
The State Health Insurance Assistance Program (SHIP) is a free and impartial counseling program for people with Medicare. SHIP is provided by the Administration on Community Living and the Indiana Department of Insurance.
The Special Enrollment Period is a period of time outside of Open Enrollment when you can enroll in or change Marketplace plans due to a life event like moving or losing other coverage. Being pregnant doesn't qualify you for a Special Enrollment Period, but the birth of a child does.
