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Indiana Health Coverage Program Policy Manual Chapter 3500 HEALTHY INDIANA PLAN Sections 3500.00.00 – 3565.00.00

Contents 3500.00.00 ELIGIBILITY STANDARDS ....................................................................................... 2 3505.00.00 OVERVIEW OF THE HEALTHY INDIANA PLAN (HIP) ................................................ 2 3510.00.00 MCE SELECTION PERIOD FOR HIP MEMBERS (MCE LOCK-IN) ................................. 2 3515.00.00 GENERAL ELIGIBILITY REQUIREMENTS: AGE AND HEALTH INSURANCE ................. 3 3515.05.00 MEDICALLY FRAIL ..................................................................................... 4 3515.10.00 OTHER MEDICAID AND MEDICARE COVERAGE ......................................... 4 3515.15.00 MINIMUM ESSENTIAL COVERAGE OF DEPENDENTS .................................. 5 3515.20.00 OTHER GENERAL HIP ELIGIBILITY REQUIREMENTS .................................... 5 3520.00.00 CATEGORICAL ELIGIBILITY FOR HIP ....................................................................... 5 3520.05.00 AMERICAN INDIAN/ALASKA NATIVE.......................................................... 5 3520.10.00 HIP PLUS-STATE PLAN (MED 3) ................................................................. 6 3520.15.00 HIP BASIC-STATE PLAN (MED 3) ................................................................ 6 3520.20.00 HIP PLUS-STATE PLAN WITH CO-PAYS (MED 3) ......................................... 7 3520.25.00 HIP REGULAR PLUS (MED 3) ..................................................................... 7 3520.30.00 HIP REGULAR BASIC (MED 3) .................................................................... 7 3520.35.00 HIP WORKFORCE BRIDGE (MED 3) ................................................................ 8 3525.00.00 HIP EFFECTIVE DATE FOR ELIGIBILITY ................................................................... 8 3525.05.00 FAST TRACK ELIGIBILITY (FTE) ................................................................... 9 3525.05.05 FAST TRACK ELIGIBILITY (FTE) WITH CREDIT CARD .................................... 9 3525.05.10 FAST TRACK ELIGIBILITY AND PRESUMPTIVE ELIGIBILITY ........................... 9 3530.00.00 FINANCIAL ELIGIBILITY REQUIREMENTS ............................................................... 9