HOOSIER HEALTHWISE APPLICATION PDF

Complete this section if the applicant answered Yes to question #12 concerning child care expenses or care for an incapacitated adult. Does the person for. Fill Apply For Hoosier Healthwise Online, download blank or editable online. Sign, fax and printable from PC, iPad, tablet or mobile with PDFfiller ✓ Instantly. APPLICATION FOR HOOSIER HEALTHWISE. FOR CHILDREN AND PREGNANT WOMEN. State form (R8 / ) / FI Completed by Enrollment.

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Hoosier Healthwise

Advanced Search Browse All Medications: For example, a woman who is carrying one baby and lives with her husband and another child will have a family size of 4. Other health needs such as prescriptions, dental care, vision care, family planning services, and mental health services are also available as part of the Hoosier Healthwise program.

If you work part-time or have children age 2 or older, the maximum amount deducted for childcare is slightly less. Non applicaton who meet all financial and categorical requirements can be eligible for either full coverage or coverage limited to emergencies, depending on immigration status. The income limits listed above were last updated effective March 1, Family size generally does not include step-parents.

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Based on family income, children up to age 19 may be eligible for premium-free coverage, or low-cost coverage under the Children’s Health Plan – Benefit Package C heatlhwise. Hoosier Healthwise Indiana Hoosier Healthwise is a health insurance program for Indiana children, pregnant women, and low-income families. Once you fill out your application, send it to the address on the application. Low-income families can be eligible for Hoosier Healthwise Package A, if there are children under the age of 18 living with their parent s or other caretaker relative.

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Except for the Low-Income Families category, the income thresholds are based on percentages of the federal poverty guidelines and are adjusted annually after the new poverty guidelines are published. It’s best to go ahead and file your application because using the above chart to include the whole family in the family size may not be correct in your situation. Call to get information about the Hoosier Healthwise program or choose one of the items below.

In determining if your income is within the guidelines above, certain deductions apply: Hoosier Healthwise is Indiana’s healthise care program for children, pregnant women, and low-income working families. Pregnant women can be eligible for full coverage under Package A, or for pregnancy-related coverage under Package B, depending on family income and assets.

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For blended families, income of step-parents cannot cause their step-children to be ineligible. The enrolled member chooses a doctor to get regular checkups and health care for illnesses. Young adults 18, 19, and 20 who live with a caretaker relative who meets the financial requirements can be covered; however their caretaker relative is not eligible.

In determining the family size for the pregnancy categories, the number of unborn children are included. Select one of the links below to download the application or go to the program site for more information on how to apply. Health care is provided at little or no cost to Indiana families enrolled in the program.