Indiana Medicaid and Medicare Information
Many Hoosiers are enrolled in Medicare or Medicaid without realizing it—or how easily coverage can change. This page helps you understand your options, stay informed, and protect your healthcare.
Disclaimer:The information provided on this page is for general educational purposes only and does not constitute legal, financial, or medical advice. Medicare and Medicaid options vary based on individual circumstances, and coverage may be affected by changes in legislation or personal eligibility.We strongly recommend consulting with a licensed insurance agent or benefits advisor who is experienced in Medicare and Medicaid plans in Indiana. A qualified professional can help you understand your options, compare plans, and choose coverage that best fits your personal health needs and financial situation.MEDICAID vs MEDICARE
WHAT IS THE DIFFERENCE?
Medicare = age/disability-based
Medicaid = income-based
MEDICARE
Who it's for:
People 65 and older, or younger individuals with certain disabilities.
Funded by:
Federal government
Covers:
Hospital care, medical services, and prescription drugs (depending on the plan).
Income-based?
❌ No — eligibility is based on age or disability, not income.
MEDICAID
Who it's for:
People of any age with low income.
Funded by:
Federal and state governments
Covers:
A broader range of services, including long-term care and personal care.
Income-based?
✅ Yes — eligibility depends on income and assets.
DUAL ELIGIBILITY:
A person can be enrolled in both Medicaid and Medicare—two separate government health programs that work together to provide more complete coverage.
Why It Matters:
Dual enrollment helps reduce out-of-pocket costs and ensures broader access to care. It’s especially valuable for people with chronic conditions or limited income.
What Is Medicaid?
Medicaid is a state and federal program for people with low income, regardless of age. It covers a wider range of services, often with little or no cost.
As of August, 2025, there are more than 12,000 residents of Hancock County rely on some type of Medicaid nearly 1 in 5 residents.
Coverage is at risk!
Hoosier Healthwise
Who it's for: Children, pregnant women, and low-income families
Key features:
Doctor visits
Prescriptions
Dental and vision care
Healthy Indiana Plan (HIP)
Who it's for: Adults aged 19–64 with income below 138% of the federal poverty level
Key features:
POWER accounts
Preventive care
Low monthly premiums
Medicaid for Aged, Blind, and Disabled (ABD)
Who it's for: Individuals with low income who are aged, blind, or disabled
Key features:
Traditional Medicaid coverage
Long-term care options
Hoosier Care Connect
Who it's for: Aged, blind, or disabled individuals not eligible for Medicare
Key features:
Managed care
Care coordination
Extra support services
Medicare Savings Programs (MSPs)
Who it's for: People who qualify for both Medicare and Medicaid (dual eligible)
Key features:
Help with Medicare premiums
Coverage for deductibles and coinsurance
In 2025, Indiana lawmakers passed Senate Bill 2 (SB 2) and Senate Enrolled Act 2 (SEA 2) - two major pieces of legislation that could significantly reduce Medicaid coverage across the state.
Legislative Changes That Could Impact Your Indiana Medicaid Coverage
What’s Changing?
• Enrollment Cap: The Healthy Indiana Plan (HIP) will be capped at 500,000 people, nearly 200,000 fewer than current enrollment.
• Work Requirements: Able-bodied adults on HIP must work or volunteer at least 20 hours per week unless they qualify for an exemption (e.g., pregnancy, caregiving, substance abuse treatment).
• Stricter Eligibility Checks: The Family and Social Services Administration (FSSA) will conduct more frequent eligibility reviews and share data with other agencies to remove ineligible individuals.
• Hospital Restrictions: Hospitals that repeatedly offer short-term coverage (presumptive eligibility) to people who don’t qualify may lose the ability to do so in the future.
Why This Matters
These changes could result in:
• Loss of coverage for thousands of working Hoosiers
• Reduced access to care in rural areas
• Financial strain on local hospitals, especially in counties without hospital infrastructure
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Republican lawmakers say the goal is to control rising Medicaid costs, which have increased by $5 billion over the past four years.
We ask: If enrollment is increasing, doesn’t that mean there are more Hoosiers suffering and needing extra help? Shouldn’t we work on job creation, better education and ways to not need assistance as much instead of hurting our neighbors more?
These decisions will harm vulnerable populations and destabilize local healthcare systems. It is not right for Hoosiers. We deserve better.
What You Can Do
Check your eligibility regularly to avoid losing coverage
Talk to a licensed insurance agent who understands Medicaid and Medicare options
Contact Indiana SHIP for free counseling: in.gov/ship
Stay informed about future legislation and how it may affect your benefits
Contact your representatives—often
Call, email, or write to them multiple times a month
Tell them how these changes are hurting you, your family and your community
Tell them you want to vote for leaders who protect and nurture a healthy society
Make it clear: this legislation does not do that!
Ultimately, the only thing that will make this better is to vote for Democratic Candidates in 2026. Please commit to doing that!
People. Progress. Possibilities
Because Every Life Deserves Dignity through proper Healthcare.
What Is Medicare?
Medicare is a federal program for people 65 and older or those with certain disabilities. It helps cover hospital, medical, and prescription costs.
Part A – Hospital insurance (premium-free for most)
Part B – Medical insurance (doctor visits, outpatient care)
Part C – Medicare Advantage
Part D – Prescription drug coverage
Private plans that bundle hospital, medical, and often prescription coverage. Many include dental, vision, and wellness benefits.
Indiana Providers Include:
Aetna Medicare
Anthem Blue Cross Blue Shield
Cigna
Humana
UnitedHealthcare
Wellcare
Standalone plans for those on Original Medicare. Covers medications and can be bundled with Advantage plans.
As of 2025, approximately 10,000 residents in Hancock County, Indiana are enrolled in Medicare programs.
This includes:
• Individuals aged 65 and older
• People under 65 with qualifying disabilities
• Residents with End-Stage Renal Disease (ESRD) or ALS
How Current Legislation Could Impact Medicare Recipients in Indiana
1. Hospital Closures and Service Reductions
Your Choices of where to go the doctor may be reduced - and further away.
With $12.7 billion in projected losses to Indiana hospitals over the next decade due to Medicaid reimbursement cuts, many facilities are scaling back services.
Need Emergency Care? Having services too far away could cost you your life. Your small-town clinic or hosptal may have to close due to lack of funding.
You may wait longer to get an appointment
Since 67% of hospital care is paid for by Medicare or Medicaid, Medicare patients will feel the strain.
Longer wait times: More patients at the same office means you wait longer to get an appointment. Once you are there, you may sit in the waiting room longer, waiting to be seen.
Fewer specialists: Have cancer, diabetes, heart condition or other special need? You may not good options to choose from.
2. Cost Shifting
Hospitals losing Medicaid revenue may raise prices for Medicare-covered services to offset losses.
Already frustrated with how much you have to pay out-of-pocket? Expect to pay even more.
Like it or not, medical services are a buisness and if they do not have the money to pay their Doctors, Nurses, staff and equipment, they cannot serve you.