Overview

Traditional Medicaid provides full health care coverage to individuals with low income. Eligibility is based on the member's aid category. Members in the following categories will be covered by Traditional Medicaid:

• Members eligible for home and community-based services

• Members who are dually eligible for Medicare and Medicaid

• Members in nursing homes, intermediate care facilities for the intellectually disabled, and state-operated facilities

Covered Services

IMPORTANT: All Indiana Medicaid programs started covering over-the-counter (OTC) Covid-19 tests on February 1, 2022 through the pharmacy benefit:

• If you are on Traditional Medicaid, you may go to any Indiana Medicaid-enrolled pharmacy and request up to two tests per member per seven days.
• If you are in a managed care program (HIP, Hoosier Healthwise, Hoosier Care Connect), you may go to a pharmacy in your health plan’s network and request up to two tests per member per seven days.

Traditional Medicaid benefits include all services that are covered under Package A – Standard Plan. Refer to the Indiana Medicaid Covered Services webpage for a list of covered services.

Member Information

• For eligibility information, including income requirements for Traditional Medicaid, refer to the Eligibility Guide.

• When you apply for Medicaid, you will automatically be enrolled in the program that is right for you.

• If you are enrolled under Traditional Medicaid, you must go to providers who accept Indiana Medicaid. To locate providers in your area, you can use the Provider Locator.

• If you are enrolled in Traditional Medicaid, the way you find rides to and from the doctor's office or other medical provider is getting easier. Click here to read about a new service that will coordinate your non-emergency transportation.

Provider Information

• Providers serving Traditional Medicaid members must be enrolled with the Indiana Health Coverage Programs (IHCP). Refer to the Become a Provider webpage.

• Providers are reimbursed by the IHCP for services rendered to Traditional Medicaid members, on a fee-for-service (FFS) basis.

• Additional provider resources regarding Traditional Medicaid services include:

  • Member Eligibility and Benefit Coverage provider reference module

  • IHCP provider news, bulletins, and banners

  • IHCP Provider Reference Modules