HIP Work Requirements Partner Toolkit

You can meet the rule by working/volunteering/training for 80 hours, earning enough money, or being in school at least half time.

Medically frail will be determined by the State. Physicians, and other clinicians, may provide recommendations on the medical history of their patients.

SUD treatment may or may not include drug court for some individuals. However, drug court is not a factor in determining medically frail status, compliance with HIP Work Requirements or an exemption from the work requirements.

No, medically frail status is only one possible exemption and is not treated as a separate determination. If no activities or exemptions are present for a member, they will receive a Notice of Non-Compliance with HIP Work Requirements.

A form will be available, and use of the form will ensure that all relevant information is provided; however, official documentation from the community agency (for example, a statement from a supervisor on their letterhead, with contact information included) would also be acceptable.

This would not count as volunteer hours, but significant and consistent assistance for a child under age 14 or a disabled individual may qualify as family caregiving. A relative or household member providing such care may qualify for the family caregiver exemption. A non-relative who does not live with the individual for whom they provide care can have the caregiving hours counted towards the 80-hour requirement.

No, this is not a countable activity.

Paid time off will be counted in the income calculation, but unpaid hours will not. An individual requiring significant time off of work due to a medical issue may pursue a medically frail determination.

To convert income into hours, divide the gross income by $7.25 (current federal minimum wage).  For example, earnings of $507.50 in a month divided by 7.25 would equal 70 hours towards meeting HWR. 

Presumptive eligibility will require pre-screening of compliance with HIP work requirements. More guidance will be released to providers on this requirement.  

Individuals receiving limited benefits such as emergency services only or family planning only are not subject to the requirements.

No, artificial intelligence is not being used to process applications.  

One option is use of a Certified Navigators or Application Organization.  These individuals are trained and available to assist members of the public with completing Indiana Health Coverage Program applications at no cost. More information is available here.  

Yes, there are several including Indiana 211, WorkOne Centers and Managed Care Organizations.

Indiana 211: Indiana 211 is a free, confidential service connecting Hoosiers with local health and human services, including food, housing, utility help, health care, disaster recovery support and other community resources. Call 2-1-1, text your ZIP Code to 898-211 or visit IN211.org to find available resources in your community.

WorkOne Centers: Need help finding a job, want to explore careers or get career advice? Contact your local office to talk with an expert and learn about the programs and services available through WorkOne Centers.

Managed Care Organizations (MCO): Individuals can contact their MCO and request assistance with locating resources that aid in meeting the work requirements.

• Anthem - 866-408-6131
• CareSource Indiana - 844-607-2829
• Managed Health Services - 877-647-4848

Requirements begin for new applicants and redeterminations initiated on or after January 1, 2027. For applicants in January, this means that requirements must be fulfilled for October, November, and December. 

Most HIP members ages 19–64 must meet work requirements unless they qualify for an exemption.

People who are pregnant, caring for kids, have disabilities or serious health needs, or drug or alcohol treatment programs, or meet other criteria don’t need to complete hours.

FSSA is still working with the Centers for Medicare and Medicaid Services on the medical frailty requirements for HIP Work Requirements exclusions, including the stipulation that the condition significantly impairs the individual’s ability to comply with work/community engagement requirements. More guidance will be made available.

Yes, it is possible that members in the same household could have different redetermination dates. You can find your redetermination date in the Benefits Portal, under Assistance Group.

You can find your redetermination date in the Benefits Portal, under Assistance Group.

Yes, and you will be notified if it changes. You can also find your redetermination date in the Benefits Portal, under Assistance Group.

For new applicants to be approved for HIP, the lookback period will be three months before the application month.

• Example: Apply in January, look back will be December, November and October.

For existing HIP members, the lookback period will be three months before the renewal month or three months before the quarterly work requirements review.

• Example: Renewal month is May, look back will be April, March and February

Correct. The requirement is either 80 hours of qualifying activity or income equal to federal minimum wage multiplied by 80 ($7.25 x 80 = $580).

Coursework at an accredited institution of higher learning, as well as high school or GED courses, can be counted. Classes may take place in-person or online.

An individual can provide documentation of the hours of self-employment and/or earnings by the most recent year’s tax returns or other business documentation.

All income that is counted in Modified Adjusted Gross Income (MAGI) budgeting counts towards meeting work requirements. This would include any income which is taxable, as well as Social Security income.

Any mix of work, volunteering, classes, or job training counts.

The state checks every three months. If they can't confirm your hours or exemption, they’ll send you a notice asking for proof.

Coverage stops, and you must reapply. You also can’t get Marketplace financial help during this time.

You renew HIP every six months, and the state checks your hours every three months.

Report changes in work, school, health, or family within 10 days using the online portal, phone, mail, or a DFR office:

Benefits Portal: Submit information to the Division of Family Resources via your FSSA Benefits Portal account at FSSABenefits.IN.gov

Mail: FSSA Document Center, PO Box 1810, Marion, IN 46952

Phone: Call DFR at 1-800-403-0864

In-Person: Visit your local Office of the Division of Family Resources during regular business hours - 8:00 a.m. to 4:30 p.m., Monday – Friday, except for State Holidays

The Benefits Portal is the easiest way to report hours and manage your HIP coverage.

Make sure your info is correct, check if you have an exemption, plan how you’ll meet the rules, and set up an Benefits Portal account.