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Is Indiana's Medicaid expansion (HIP) the same as long-term care Medicaid for seniors?

No. The Healthy Indiana Plan (HIP), Indiana's ACA expansion effective February 1, 2015, covers adults 19-64 based on income. Long-term-care Medicaid f

Quick answer

No. The Healthy Indiana Plan (HIP), Indiana's ACA expansion effective February 1, 2015, covers adults 19-64 based on income. Long-term-care Medicaid for seniors uses a separate, non-MAGI aged/blind/disabled eligibility pathway with different asset and income rules. The two are frequently and incorrectly conflated.

HomeQuestionsIs Indiana's Medicaid expansion (HIP) the same as lo
Answer

No. The Healthy Indiana Plan (HIP), Indiana's ACA expansion effective February 1, 2015, covers adults 19-64 based on income. Long-term-care Medicaid for seniors uses a separate, non-MAGI aged/blind/disabled eligibility pathway with different asset and income rules. The two are frequently and incorrectly conflated.

The detail behind the program

This distinction trips up more families than almost any other Medicaid question we hear. HIP eligibility is based mainly on modified adjusted gross income, similar to ACA marketplace rules, and stops applying once someone qualifies for Medicare at 65. Long-term-care Medicaid for a senior in assisted living or a nursing home runs through an entirely different set of rules -- asset limits, a special income limit, and spend-down calculations that have nothing to do with HIP's income brackets. If a hospital social worker or a facility mentions 'Medicaid eligibility,' ask specifically which pathway they mean.

Related questions

Questions families ask

Is Indiana's Medicaid expansion (HIP) the same as long-term care Medicaid for seniors?

No. The Healthy Indiana Plan (HIP), Indiana's ACA expansion effective February 1, 2015, covers adults 19-64 based on income. Long-term-care Medicaid for seniors uses a separate, non-MAGI aged/blind/disabled eligibility pathway with different asset and income rules. The two are frequently and incorrectly conflated.

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