Provider News


Presumptive Eligibility Program Changes

Posted by & filed under Blog, Provider News.

Are you familiar with the recent changes to the Presumptive Eligibility program?

As of April 1, 2014 the application process and eligibility requirements has changed to allow for greater ease of use, and for greater access to the program:

  • Applicants may now self-attest to their pregnancy
  • The income limit increased to 213% of the federal poverty level (FPL), including an allowable 5% income disregard
  • Six of the application fields are now listed as optional, including: Social security number, race, ethnicity, gender, marital status, and whether the applicant has a pending Indiana Application for Health Coverage.

Next steps

After the provider completes the application online, either an approval or denial letter will be available to print. The approval letter provides further direction how she can continue her coverage. However, providers are encouraged to walk through these next steps with the patient.

More about the Presumptive Eligibility for Pregnant Women program

The Presumptive Eligibility (PE) program is for pregnant women in Indiana who find themselves without health insurance coverage during pregnancy. Qualified providers can submit applications for the patient while she is in-office for a check-up, and can receive $60 per successful submission.

Providers can submit applications via the HP Web interchange

Learn more about PE on IndianaMedicaid.com