AMBER ALERT

But when you're done reading it, click the close button in the corner to dismiss this alert.

GLOBAL MESSAGE

But when you're done reading it, click the close button in the corner to dismiss this alert.

Header

Agency Links
IN.gov Links
Become a Provider Icon Provider Enrollment
Provider Education Icon Provider Education
Business Transactions Icon Business Transactions
Clinical Services Icon Clinical Services
About IHCP Programs Icon About IHCP Programs

Presumptive Eligibility for Inmates

NOTE: County jails interested in participating in the Presumptive Eligibility for Inmates (PE for Inmates) process should send an email to IndianaInmateMedicaid@fssa.in.gov.

The PE for Inmates process allows acute care hospitals that are qualified providers (QPs) for Presumptive Eligibility (PE) to enroll eligible inmates into the Indiana Health Coverage Programs (IHCP) for temporary coverage of authorized inpatient hospitalization services.

PE for Inmates is available to individuals who meet the following requirements. The individual must:

  • Be an inmate from a correctional facility operating under the memorandum of understanding or contract with the Indiana Family and Social Services Administration (FSSA)
  • Not be on house arrest
  • Not be pregnant or admitted for labor and delivery
  • Be admitted for inpatient hospitalization
  • Be under the age of 65
  • Meet all other standard PE requirements

Inmates who go through the PE process must complete an Indiana Application for Health Coverage to retain inpatient benefits. Individuals who complete applications and are found eligible will be covered for 12 months under the Medicaid Inpatient Hospital Services Only benefit plan. If the inmate does not complete an Indiana Application for Health Coverage, his or her presumptive eligibility coverage will end on the last day of the month following the month in which the individual was found presumptively eligible. If the individual remains incarcerated after one year, he or she may reapply for coverage through the PE for Inmates process.

Services rendered to individuals covered under Medicaid Inpatient Hospital Services Only (through the PE for Inmates process) will be reimbursed through the fee-for-service (FFS) delivery system at FFS rates. Providers are reminded to always verify individuals' eligibility before rendering services. Eligibility can be verified by using any of the following Eligibility Verification System (EVS) options:

More information about PE for Inmates is available through the following links:

Direct additional questions or concerns to IndianaInmateMedicaid@fssa.in.gov.

News & Announcements