Apply for hoosier healthwise online form 2025

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The document is an application form for the Hoosier Healthwise program, which provides health coverage for children and pregnant women in Indiana. It includes sections for personal information, household details, income reporting, and eligibility criteria for different benefit packages. The form also outlines the rights and responsibilities of applicants, including the requirement to provide accurate information and the assignment of medical rights. Additionally, it explains the benefits available under various packages and emphasizes confidentiality and non-discrimination.

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Click ‘Get Form’ to open the apply for Hoosier Healthwise online form in our editor.
Begin by entering your family members' details. List your name first, followed by children, spouses, and parents. Ensure to fill in their date of birth, social security number, marital status, race, sex, and indicate if they are applying for health coverage.
Provide your home address and contact information. If you have a different mailing address, include that as well.
Answer questions regarding residency in Indiana and any legal guardianship status of applicants.
Indicate if any applicants are pregnant or have disabilities. Fill in relevant details such as due dates and doctor information.
Report current health insurance coverage status and any recent loss of coverage along with reasons.
Detail household income from work and other sources. Include gross pay amounts and payment frequency.
Complete the assignment of rights section by signing where indicated to assign medical support rights.
Review all provided information for accuracy before submitting the application.

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Who is eligible for the Hoosier health Card in Indiana?

3. Be a member of a family that has income between 150% and 200% of the federal income poverty level. Eligibility is based on income levels, and the levels change yearly, so contact Hoosier Healthwise to find out if you are eligible based on your income.

How do I apply for the Healthy Indiana Plan?

Applications are available online, by mail, or by visiting your local Division of Family Resources (DFR) office. Call 1-877-GET-HIP-9 for more information about the application process or to find your local DFR office. Send in the application with all required information.

Is Healthy Indiana Plan the same as Medicaid?

Members pay affordable monthly contributions, and the only other cost for health care in HIP Plus is a payment of $8 if you visit the emergency room when you dont have an emergency health condition.

How much does a two-person household have to make to qualify for Hoosier Healthwise?

Income / family size Family sizeIncome limit (per month) 2 $3,754.15 3 $4,731.05 4 $5,707.00 5 $6,682.90

How long does it take to be approved for Indiana Medicaid?

You can apply in person, online, by mail, or by phone. Once you submit your complete application, it can take up to 90 days to determine if you are eligible. If you are a pregnant woman, you may be able to receive medical care while you wait for your application to be processed.