December 18, 2018
Indiana Medicaid announced that, effective January 1, 2019, adults determined to be presumptively eligible for Medicaid will receive fee-for-service benefits during the presumptive eligibility (PE) coverage period. This change means that the enhanced benefits and additional flexibilities previously available during the PE coverage period through managed care will no longer be available to PE adults in fee-for-service as summarized below. The full copy of the Indiana Health Coverage Program (IHCP) bulletin is available here.
Importantly, once individuals complete the application and eligibility process to transition to full Medicaid coverage, the individual will have full access to all of the typical benefits available through managed care. Therefore, it will become even more important to ensure timely completion of the full Medicaid application following the initial PE determination.
For individuals eligible for the Healthy Indiana Plan, the fast track option is also available to further reduce the time prior to full coverage. Fast track allows an applicant to pay a POWER account contribution at the time of application or any time prior to the state’s eligibility determination. Once the applicant is determined eligible for Medicaid, the individual’s Medicaid eligibility dates back to the first day of the month in which the fast track payment was made, which can be as early as the first day of the month in which the application was filed.