Indiana Medicaid Income Limits. I know how overwhelming it can feel if you’re trying to apply for Medicaid or the Healthy Indiana Plan (HIP) in Indiana. You’re worrying about forms, income documents, whether your job or your partner’s earnings disqualify you, and most sites give generic, vague statements.
I’ll explain exactly what counts as income, what the thresholds are for different groups, like parents, pregnant people, children, disabled folks, and how to apply. I’ll also answer pressing questions like “What is the maximum income to qualify for Medicaid in Indiana?” and “Does Indiana have different income limits for parents/caretaker relatives?”.
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What Is Medicaid in Indiana?
When I talk about Medicaid, I mean the state‑run program that helps low‑income people get health coverage. In Indiana, that includes what’s often referred to as “traditional Medicaid” for children, pregnant people, parents, the elderly, and people with disabilities. I want you to know that Indiana Medicaid income limits are basically the financial thresholds you must stay under if you want to qualify.
Indiana Medicaid covers essential services, doctor visits, hospital stays, prescriptions, preventive care, and sometimes dental and vision, depending on your category. If you only heard about HIP, I’ll get to that in a moment.
Healthy Indiana Plan (HIP) vs Traditional Medicaid
HIP (Healthy Indiana Plan) is Indiana’s version of Medicaid expansion under the ACA. Even though some people muddle it with traditional Medicaid, here’s how they differ:
- HIP is generally available to adults under 138% of the federal poverty level (FPL), even if they wouldn’t qualify under traditional Medicaid rules.
- HIP may require a small monthly premium payment (called POWER account contributions), and generics co‑pays.
- Traditional Medicaid typically has no premiums and more robust coverage for eligible groups.
Who Is Eligible for Medicaid in Indiana?
Groups Covered: Children, Parents, Pregnant People, Disabled, and Seniors
To figure out if you qualify under Indiana Medicaid income limits, you need to know your eligibility category:
- Children (up to age 19): Most kids in families earning up to 317% FPL (varying by age/tier) may qualify for Hoosier Healthwise.
- Pregnant people: Up to 195% FPL during pregnancy and up to about 65 days postpartum.
- Parents and caretaker relatives: Usually up to around 17–19% FPL under traditional Medicaid, but HIP covers parents up to 138%.
- Adults without dependent children: Normally don’t qualify under traditional Medicaid, but HIP covers up to 138% FPL.
- Aged (65+), blind, or disabled adults: Income limits are usually set at 100% FPL, sometimes with deductions.
- Individuals needing long‑term care or nursing home support: Income rules are often stricter and include “spend‑down.”
Citizenship and Residency Requirements
To qualify, you have to be:
- A U.S. citizen or a lawful permanent resident (with some waiting periods for recent green card holders).
- A resident of Indiana, living in the state, intending to stay here.
- And of course, you must provide documentation, Social Security number, photo ID, proof of address, and proof of income.
These rules are standard; they don’t affect the income limits directly, but they do affect whether your household income is considered at all.
How Does Medicaid Work in Indiana? The Basics Explained
Application Process
Here’s what you’ll do:
- Gather documents: pay stubs, benefit letters, Social Security info, ID, and utility bill for address.
- Apply online via IN.gov or FSSA’s portal. You can also apply via mail or through an authorized local partner.
- Provide income information about everyone in your household who’s required.
- Answer questions about pregnancy, disability, caregiving, etc.
- Wait for eligibility determination (usually within 45 days; for disability, it can take longer).
They’ll check your income against the Indiana Medicaid income limits category by category. If you’re accepted, they’ll assign you to traditional Medicaid or HIP, depending on your income level.
What Happens After Approval? Services and Benefits
If you qualify:
- You’ll get an Indiana Medicaid ID card or HIP card.
- You’ll receive coverage for eligible benefits regular doctor visits, emergency services, mental health, Rx drugs.
- If you’re on HIP, you’ll also manage your small POWER account.
- You’ll need to recertify each year (or sooner, if circumstances change).
Importantly, income verification happens at every renewal, so staying under the threshold year‑to‑year is key. That’s why understanding income limits is so important.
Indiana Medicaid Income Limits (2025 Figures)
These figures reflect the official limits as of early 2025. Numbers come from Indiana Family and Social Services Administration (FSSA) guidelines and are linked to the Federal Poverty Level (FPL) for a household of given size.
Children and Families
- Children ≤ 1 year old: up to about 317% FPL.
- Children aged 1–5 and 6–18 get different sliding thresholds down to about 142% FPL.
- Hoosier Healthwise also includes CHIP coverage with income tiers slightly above Medicaid’s baseline.
Families with older children may qualify even if parents don’t, based on those children’s higher FPL percentage threshold.
Parents and Caretaker Relatives
With traditional Medicaid, the cap is low usually around 17%–19% FPL of household income. For example:
- A family of three might qualify only if their income is under about $5,000 annually.
- However, if parents fall under the HIP category, they can qualify up to 138% FPL, which is roughly about $24,000 for a family of three in 2025.
Pregnant People
Income eligibility extends to 195% FPL during pregnancy and postpartum. For instance, if you’re pregnant with one dependent, and your income is under around $35,000/year, you might qualify.
Aged, Blind, and Disabled Programs
Those categories typically qualify up to 100% FPL. So a single individual earning under roughly $14,600/year (in 2025) could be eligible for Medicaid coverage tailored to disabilities or ageing.
Healthy Indiana Plan Income Thresholds
HIP wraps around these limits: adults up to 138% FPL, including childless adults and parents. It’s considered Medicaid expansion; no adult can be denied if under that threshold, even if traditional Medicaid rules would’ve disqualified them.
What Is the Maximum Income to Qualify for Medicaid in Indiana?
This is the big question, right? And the answer depends entirely on who you are and what type of Medicaid you’re applying for. There’s no one-size-fits-all number, but I’ll give you the range.
For most adults under HIP, the maximum income to qualify for Medicaid in Indiana is 138% of the federal poverty level (FPL). In real dollars (based on 2025 figures), that translates to:
- $20,783/year for a single adult
- $28,208/year for a couple
- $42,427/year for a family of four
If you’re applying under traditional Medicaid as a parent or caretaker, it’s way stricter: only about 17% FPL. That’s $3,000–$5,000/year, depending on household size, and almost no one qualifies under that unless they’re truly destitute.
For pregnant individuals, the maximum jumps up to 195% FPL. And for kids, the cap is higher still; some kids may qualify even if family income reaches 317% FPL.
So if you’re asking, “What’s the income cap?” you need to ask: for whom? A single mom, a pregnant student, and a retired person with disability benefits all have different ceilings.
Also, Indiana considers gross monthly income (before taxes) for most programs. So even if your take-home pay feels small, your pre-tax amount is what they’re looking at.
Does Indiana Have Different Income Limits for Parents/Caretaker Relatives?
Absolutely, and this part trips up a lot of people.
Indiana splits eligibility between two programs:
Traditional Medicaid for parents/caretakers
This is very strict. Income must be around 17–19% of the FPL. Think $300–$500/month for a single parent. Practically speaking, almost no working parent qualifies unless they have zero income or rely entirely on public assistance.
Healthy Indiana Plan (HIP)
Much more forgiving. Parents or caretakers under 138% of FPL can apply. This group includes a ton of working-class families: retail workers, restaurant staff, and people with part-time jobs or small businesses.
Let’s say you’re a single mom with one child and you earn $1,800/month. That disqualifies you from traditional Medicaid, but HIP would accept you. You’d probably owe a small monthly payment (like $10 or $15), but you’d still get full coverage.
And one note: if you’re a caretaker (like watching a grandchild or disabled sibling), even if you’re not their legal guardian, you might still qualify under this category. That’s where those lower income thresholds could work in your favor.
Do I Qualify for Medicaid Premium Tax Credits in Indiana?
This one confuses a lot of people because Medicaid and tax credits come from two totally different laws, but I’ll explain it simply.
You can’t get premium tax credits (PTCs) from the federal government if you qualify for Medicaid. But here’s where it gets tricky:
- If you don’t qualify for Medicaid because your income is too high, and you don’t have access to employer coverage, then yes, you may get premium tax credits through the HealthCare.gov marketplace.
- If your income is below the Medicaid threshold but you’re not eligible for Medicaid due to immigration status, you might still qualify for credits.
Let me put it this way: You get either Medicaid or tax credits. Never both.
So if you’re in the coverage gap (your income is too high for Medicaid but too low for tax credits, rare in Indiana due to HIP), then you need to talk to a navigator or benefits counselor.
Also, if your income changes midyear, say, you lose your job or pick up a better-paying one, you could flip between Medicaid and marketplace tax credits. Indiana tracks this through renewal checks and mid-year reporting.
So, no, you don’t qualify for Medicaid premium tax credits in Indiana, but you might qualify for one or the other based on income and family size.
What Is the Highest Income to Qualify for Medicaid?
This is a variation of the earlier question, and again, it depends on who you are. So let me put it this way:
| Eligibility Group | Max % of FPL | Approx. Max Yearly Income (Family of 1) |
| HIP Adults (19–64, no disability) | 138% | ~$20,783 |
| Pregnant People | 195% | ~$29,370 |
| Children (0–18) | 142%–317% | ~$33,000+ (depending on age) |
| Elderly/Disabled (SSI-based) | 100% | ~$14,600 |
| Parent/Caretaker (traditional) | 17–19% | ~$3,400 |
So the highest income to qualify for Medicaid in Indiana is roughly 317% FPL for children and 195% FPL for pregnant individuals. Most adults fall under the HIP limit of 138%.
A lot of folks earn just over these thresholds and assume they’ll still qualify, but if you’re over by even $1, you’re technically not eligible. Some people try to “spend down” or reduce income through deductions, and we’ll go over that soon.
But yes, there is a hard income line, and it varies from group to group.
What Is the Income Limit for Healthy Indiana Plan?
Now we’re really zoning in. The Healthy Indiana Plan (HIP) has a very specific income limit:
- 138% of the Federal Poverty Level
- For a single adult in 2025, that means $1,732/month pre-tax
Here’s a quick breakdown by household:
| Household Size | Monthly Income Limit (2025) |
| 1 | $1,732 |
| 2 | $2,351 |
| 3 | $2,970 |
| 4 | $3,588 |
HIP is available to adults aged 19–64 who aren’t eligible for Medicare or SSI and meet residency requirements. This includes single adults, childless couples, and even parents who don’t meet traditional Medicaid standards.
HIP has two main versions:
- HIP Basic: Free coverage, but you have co-pays.
- HIP Plus: Includes vision, dental, and better coverage, but you pay a small monthly POWER contribution ($1–$27 based on income).
If your income is just barely over the HIP limit, you’ll get a denial, but sometimes you can still appeal or request a manual review if your income fluctuates.
What Is the Monthly Income Limit for Medicare in Indiana?
Here’s where it gets confusing, so stay with me: Medicare is not income-based like Medicaid. You qualify for Medicare primarily based on age (65+) or disability (receiving SSDI for 24+ months). But when people ask about “income limits” for Medicare, they usually mean one of two things:
Do I qualify for help paying Medicare costs (through Medicaid)?
Will my income affect what I pay for Medicare premiums (IRMAA)?
Let me explain both quickly.
1. Medicare Savings Programs (MSPs)
If your income is low enough, Indiana can help pay for your Medicare Part B premium, deductibles, and even co-pays. These programs are run through Medicaid. The monthly income limits for 2025 (based on MSPs) are about:
- $1,549/month for individuals
- $2,080/month for couples
These limits are approximate and adjust slightly each year.
If you qualify, you may get help with:
- Your monthly Part B premium (which is about $174 in 2025)
- Deductibles and co-insurance (depending on the tier)
- Automatic enrollment in Extra Help, which reduces Part D costs
2. IRMAA (Income-Related Monthly Adjustment Amount)
If your income is too high (over $103,000 for individuals or $206,000 for couples), Medicare starts charging you more for Part B and Part D. So while there’s no “income limit” to get Medicare, there are definitely income thresholds that affect what you pay.
So when someone asks, “What is the monthly income limit for Medicare in Indiana?” the answer is: It depends on what help you need. You can earn more than the Medicaid threshold and still get Medicare, but if you’re low-income, Medicaid can help cover those costs.
Claimed vs Countable Income: What Counts and What Doesn’t
One of the most misunderstood parts of Indiana Medicaid income limits is how income is actually counted. You might think, “I make $2,000 a month, so I’m over the limit.” But not so fast Indiana uses countable income, which isn’t always the same as what you claim on your taxes.
Deductions and Disregards
Indiana Medicaid subtracts certain things from your gross income:
- $20 general income disregard (everyone gets this)
- $65 of earned income + 50% of remaining earned income is excluded
- Child care costs
- Work-related expenses for disabled individuals
Let’s say you earn $2,000/month from your job. Indiana will deduct $65, then exclude half of the remaining income ($967.50), making your countable income only $967.50, well under the HIP limit.
This is one reason it’s worth applying even if you think you’re over the limit.
How Self‑Employment Income Is Calculated
For self-employed people gig workers, freelancers, hair stylists Indiana looks at net income, not gross.
So if you bring in $3,000 but have $1,500 in business expenses (like gas, supplies, internet, etc.), only the remaining $1,500 is counted. And then Indiana still applies deductions on top of that!
You may need to submit:
- Tax returns (Schedule C)
- Expense logs
- Business bank statements
Self-employed income can fluctuate, so Indiana may average your monthly income over several months. That’s why documenting everything is crucial.
FAQs
What is the maximum income to qualify for Medicaid in Indiana?
For adults without disabilities, it’s 138% of FPL about $1,732/month for one person. Other categories like pregnant women or children have higher limits.
What is the highest income to qualify for Medicaid?
That would be 317% FPL for certain children under Hoosier Healthwise. Pregnant women also qualify up to 195% FPL.
What is the income limit for Healthy Indiana?
HIP covers adults up to 138% of the FPL. For a single adult in 2025, that’s about $1,732/month or $20,783/year.
What is the monthly income limit for Medicare in Indiana?
There’s no income limit for Medicare itself, but Indiana’s Medicare Savings Programs help low-income Medicare recipients. For example, QMB covers those earning less than $1,275/month individually.
What is Indiana Medicaid income limit?
It varies by group: from about $300/month for traditional Medicaid parents to over $3,000/month for families with children under Hoosier Healthwise.
Does Indiana have different income limits for parents/caretakers?
Yes. Traditional Medicaid has a much lower income limit for parents about 17–19% of the FPL. But HIP expands coverage up to 138%.
Do I qualify for Medicaid premium tax credits in Indiana?
No, you either qualify for Medicaid or tax credits, not both. If you’re eligible for Medicaid, you can’t get tax credits on HealthCare.gov.
Does Indiana have Medicaid?
Yes! It’s run by the Indiana Family and Social Services Administration (FSSA). Programs include traditional Medicaid, Hoosier Healthwise, HIP, and others.
How does Medicaid work in Indiana?
Once approved, you get coverage through a managed care plan (like MDwise or Anthem) and can access services like doctor visits, prescriptions, and preventive care. Some people pay premiums (HIP Plus), while others get coverage free.
Who is eligible for Medicaid in Indiana?
Eligibility depends on age, pregnancy status, disability, income, and residency. Children, pregnant people, seniors, low-income adults, and people with disabilities are all potential candidates, if they meet income thresholds.
Conclusion
Now you know Indiana Medicaid income limits aren’t as straightforward as they first seem. They change depending on whether you’re applying for yourself, your child, or your entire family. The key thing I’ve learned is this: don’t assume you’re not eligible just because you have a job or some income. The limits are more flexible than you think, especially if you’re applying under HIP or for children.
Also, keep in mind that countable income is different from what you see on your pay stub. Deductions, self-employment rules, and different household scenarios all play a role. If you’ve been denied in the past, consider applying again, especially if your financial situation has changed.
And always double-check the most recent income thresholds, because they adjust every year.
If you’re still unsure, call the Indiana FSSA or connect with a certified health navigator, they’ll walk you through it, judgment-free.