Proposed Indiana Medicaid Rule Changes


The Indiana Family and Social Services Administration has proposed major changes in the Indiana Medicaid Program.  The Indiana Medicaid rule changes proposed for June 1, 2014, include:

  1.          Indiana will now defer to disability determinations made by the Social Security Administration.
  2.          Folks on SSI will automatically be enrolled in Medicaid.
  3.          The “spend down” provisions will be eliminated for most folks receiving Medicaid benefits in the community.
  4.          The asset limit will increase from $1,500 to $2,000 for a single person and from $2,250 to $3,000 for a married couple.
  5.          The “spend down” system will be replaced by four programs, depending on your income.
    •          Hoosiers who are aged, blind and disabled at 100% of the Federal Poverty Level (“FPL”) (which is $11,670 annually for a single person, $15,730 for a     married couple, and an extra $4,432 for a qualifying child) will be enrolled in Medicaid without cost and without a “spend down”.
    •          The Medicare Savings Program will be expanded for dual eligibles – folks who qualify for Medicaid and Medicare.
    •          Folks earning more than 100% of FPL will be eligible to purchase a health insurance plan on the federal marketplace.
    •          Hoosiers with severe mental illness whose income exceeds 100% of FPL, who are not eligible for full Medicaid, may join the new Behavioral and Primary Healthcare Coordination Program.
  6.          As of December 2013, 65,642 Hoosiers had a “spend down”.
    •          On June 1, 2014, 23,869 Hoosiers will have full Medicaid because they are at or below 100% of the FPL.  They will be automatically enrolled in this program.
    •          On June 1, 2014, 26,879 Hoosiers between 100% and 150% of the FPL on Medicare will automatically join the Medicare Savings Program.  Indiana will pay for the Part B premium, the annual Part A & B deductibles, and Medicare copayments/coinsurance.
    •          Dual eligibles between 150% and 185% of FPL will have their Part B premium paid by the State but will lose their right to “spend down”.
    •          There are 6,906 Hoosiers in this category.
    •          7,997 dual eligible Hoosiers with income in excess of 185% of FPL will lose the “spend down” program and will not be eligible for the Medicare Savings Program.
  7.          Hoosiers receiving nursing home care or waiver services with monthly income above $2,163 will need to have a qualified income trust in place by June 1, 2014.

            You can view these changes at

Marcia A. McNagny, February 2014

Special Acknowledgment to Keith P. Huffman, Indiana National Academy of Elder Law Attorneys