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:
- Indiana will now defer to disability determinations made by the Social Security Administration.
- Folks on SSI will automatically be enrolled in Medicaid.
- The “spend down” provisions will be eliminated for most folks receiving Medicaid benefits in the community.
- 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.
- 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.
- 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.
- 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 http://www.in.gov/fssa/4859.htm.
Marcia A. McNagny, February 2014
Special Acknowledgment to Keith P. Huffman, Indiana National Academy of Elder Law Attorneys