Complete this section if the applicant answered Yes to question #12 concerning child care expenses or care for an incapacitated adult. Does the person for. Fill Apply For Hoosier Healthwise Online, download blank or editable online. Sign, fax and printable from PC, iPad, tablet or mobile with PDFfiller ✓ Instantly. APPLICATION FOR HOOSIER HEALTHWISE. FOR CHILDREN AND PREGNANT WOMEN. State form (R8 / ) / FI Completed by Enrollment.

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Except for the Low-Income Families category, the income thresholds are based on percentages of the federal poverty guidelines and are adjusted annually after the new poverty guidelines are published.

Low-income families can be eligible for Hoosier Healthwise Package A, if there are children under the jealthwise of 18 living with their parent s or other caretaker relative. In determining if your income is within the guidelines above, certain deductions apply: Non citizens who meet all financial and categorical requirements can be eligible for either full coverage or coverage limited to emergencies, depending on immigration status.

Directory Support Important Links. Website Administered by RxResource. Hoosier Healthwise Indiana Hoosier Healthwise is a health insurance program for Indiana children, pregnant women, and low-income families.


Call to get information about the Hoosier Healthwise program or choose one of the items below. Other health needs such as prescriptions, dental care, vision care, family planning services, and mental health services are also available as part of the Hoosier Healthwise program.

Applicatjon size generally does not include step-parents.

The enrolled member chooses a doctor to get regular checkups and health care for illnesses. The income limits listed above were last updated effective March 1, Hoosier Healthwise is Indiana’s health care program for children, pregnant women, and low-income working families.

Select one of the links below to download the application or go to the program site for more information on how to apply. For blended families, ohosier of step-parents cannot cause their step-children to be ineligible.

Indiana Medicaid Application & Eligibility | MHS Indiana

Pregnant women can be eligible for full coverage under Package A, or for pregnancy-related coverage under Package B, depending on family income and assets. In determining the family size for the pregnancy categories, the number of unborn children are included.

If you work part-time or have children age 2 or older, the maximum amount deducted for healtgwise is slightly less. For example, a woman who is carrying one baby and lives with her husband and another child will have a family size of 4.


It’s best to go ahead and file your application because using the above chart to include the whole family in the family size may not be correct in your situation. Once you fill out your application, send it to the address on the application.

Advanced Search Browse All Medications: Based on family income, children up to age 19 may be eligible hoosieg premium-free coverage, or low-cost coverage under the Children’s Health Plan – Benefit Package C www.

Health care is provided at little or no cost to Indiana families enrolled bealthwise the program. Young adults 18, 19, and 20 who live with a caretaker relative who meets the financial requirements can be covered; however their caretaker relative is not eligible.