Adult 1915(i) Programs

On June 1, 2014, the Indiana FSSA changed the way individuals are determined eligible for coverage under the aged, blind, and disabled Medicaid aid categories. Referencing the section numbers of the Social Security Act, Indiana transitioned from a “209(b)” state to a “1634” state.

As an agency in a 1634 state, the Indiana Health Coverage Programs (IHCP) began accepting all Social Security Administration (SSA) determinations of disability under the Social Security Disability Insurance (SSDI) program and automatically enrolling individuals determined eligible for Supplemental Security Income (SSI) benefits by the SSA. This change eliminated the arduous and duplicative requirement that aged, blind, and disabled applicants who receive SSI also complete a second application with the IHCP. Also, neither SSI nor SSDI recipients now need to go through the State’s Medical Review Team (MRT) process to be determined disabled and eligible for IHCP coverage.

With the 1634 transition:

  • Individuals receiving SSI benefits are enrolled in Medicaid automatically.
  • The state accepts SSA determinations of disability.
  • Individuals with incomes of up to 100% of the federal poverty level (FPL) who are aged, blind, or disabled are transitioned from spend-down to full Medicaid eligibility.
  • The spend-down provision is discontinued.
  • The income thresholds for the Medicare Savings Program, which provides Medicare cost-sharing assistance, are increased.

The programs included under the 1915(i) State Plan are Adult Mental Health Habilitation (AMHH) and Behavioral and Primary Healthcare Coordination (BPHC).   Also, on March 17, 2014, Centers for Medicaid and Medicare Services (CMS) implemented the Home- and Community-Based Services Final Settings Rule. Please refer to the links below for additional information for each program.