Health Coverage Fact Sheet

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					                      FACT SHEET: FSSA HeAltH CoverAge AppliCAtionS
          DFR Online/Phone Application                     Hoosier Healthwise Paper Application                             HIP Paper Application
What is it?                                             What is it?                                             What is it?
The new online and phone application can be             The purple, paper application for Hoosier               The Healthy Indiana Plan (HIP) paper
used for Cash Assistance (TANF), Food Stamps            Healthwise (HHW) is used by pregnant women              application is used to apply for the new
and Medicaid/Hoosier Healthwise. This new               and children at Hoosier Healthwise Enrollment           subsidized health plan for adults.
application is being implemented in regions.            Centers across the state.                               Who is eligible?
Who is eligible?                                        Who is eligible?                                        Non-disabled adults (ages 19-64)
Families are the most common participants in            Pregnant women and children with household              • With household income up to 200% FPL
these programs. For basic income eligibility,           income up to 200% of the federal poverty level          • Who have been uninsured for at least 6 months
see the back of this page. For more detailed            (FPL) are eligible for Hoosier Healthwise (see back).   • Who are not eligible for employer-sponsored
eligibility information, visit and      When will it be available?                               health insurance
click “Family Resources.”                               The Hoosier Healthwise paper application is             Where is the application available?
When will it be available?                              currently in use throughout the state.                  Paper applications are available at the following
Implementation occurs by region across the              Where is the application available?                     locations:
state. Implementation dates are below:                  The Hoosier Healthwise paper application is             • On the Internet at
•  Oct ‘07– Region 1 N. Central                         available at Hoosier Healthwise Enrollment              • Hoosier Healthwise Enrollment Centers
•  Mar-May‘08– Region 2 South/West/Northeast            Centers, including many health centers, social          • Local DFR offices
•  TBD– Region 3 Northwest                              service programs and schools. To find a HHW             • Call 1-877-GET-HIP-9
•  TBD– Region 4 Central                                Enrollment Center near you, visit      Benefits were available as of January 1, 2008.
Where is the application available?                     What is the difference between using the new            What does HIP require of participants?
The online or phone application can be used             online or phone application and using the               To receive benefits, participants must
anywhere – at home, a Division of Family                paper application?                                      contribute to a POWER Account, which will be
Resources (DFR) office or a Community                   If a family might be eligible for cash assistance       used to pay for initial medical expenses (similar
Access Point (service provider or community             (TANF) or Food Stamps, they can apply for all           to a deductible). Individual contributions will
organization that is registered with FSSA).             three programs –cash assistance, Food Stamps            not exceed 5% of gross household income.
How do I find the application or more information?      and Medicaid/Hoosier Healthwise using the               How can service providers or potential
Visit and click “Apply for              online or phone application. (The online                applicants get more information?
Benefits/Manage Your Benefits“ (only available          screening can advise a family of potential              • Visit or call 1-877-GET-HIP-9
when implemented in your area). For more                eligibility at, “Apply for              • To order applications or brochures, visit
information, click “Eligibility Modernization/          Benefits/Manage Your Benefits.”)                
Communications.”                                        If a pregnant woman or child is only eligible
                                                        for Hoosier Healthwise, the paper Hoosier
                                                        Healthwise application might be the fastest way
                                                        to apply.

    Indiana Family and Social Services Administration                                                                      January 2010
                                                                                                                                                            Job #5166
                          FACT SHEET: FSSA HeAltH CoverAge AppliCAtionS

                                                            Income Eligibility for FSSA Health Coverage Programs

                                                                                                                      State Child Health
                                      Standard Medicaid/ Cash                                                                                Healthy Indiana Plan
           Program                                                     Food Stamps              Hoosier Healthwise      Insurance Plan
                                         Assistance (TANF)                                                                                          (HIP)
                                                                                                                     (Package C of HHW )

                                                                                                Pregnant Women &                           Parents, Caretaker Relatives
     Eligible Members                      Parents & Children      Families & Other Adults                                Children
                                                                                                     Children                                  & Childless Adults

     Number of People
                                                 22% FPL                 130% FPL                   200% FPL              250% FPL                 200% FPL
       in the Family

                1                                 $2,383                  $14,079                    $21,660              $27,075                   $21,660

                2                                 $3,205                  $18,941                    $29,140              $36,425                   $29,140

                3                                 $4,028                  $23,803                    $36,620              $45,775                   $36,620

                4                                 $4,851                  $28,665                    $44,100              $55,125                   $44,100

                5                                 $5,674                  $33,527                    $51,580              $64,475                   $51,580

                6                                 $6,497                  $38,389                    $59,060              $73,825                   $59,060

                7                                 $7,319                  $43,251                    $66,540              $83,175                   $66,540

                8                                 $8,142                  $48,113                    $74,020              $92,525                   $74,020
* Income amounts based on 2009 Federal Poverty Level

 Indiana Family and Social Services Administration                                                                                January 2010
                                                                                                                                                                      Job #5166