Families and individuals often find themselves struggling to understand and navigate the Medicaid system. Because having an appropriate Medicaid category is necessary to maintain their waiver it is important that they receive the guidance and appropriate assistance necessary to address any Medicaid issues to avoid an interruption in services.
Division of Family Resources Benefits Portal The benefits portal allows individuals to review case information, print proof of eligibility and report changes. https://fssabenefits.in.gov/CitizenPortal/application.do
Individuals will need to create an online account at the first login.
Children under 18 Children under 18y who have been approved for waiver services are eligible for Medicaid regardless of parental income. The child’s income and assets are taking into consideration so it is important for families to consider this when planning for their child’s financial future. Families may consult with a financial planner or elder law attorney to discuss savings options for persons with disabilities that allow them to maintain their eligibility for government services.
Adults 18 and over As of June 1, 2014 Indiana transitioned to a 1634 state. 1634 status refers to a state’s method for determining Medicaid eligibility under the aged, blind, and disabled coverage category. 1634 is a section of the Social Security Act. In a “1634 state,” the Medicaid agency uses the same definition of disability as the Social Security Administration (SSA) for the purposes of determining eligibility for the Medicaid disability coverage category. When determining Medicaid eligibility for the disabled, the 1634 state accepts and gives precedence to SSA disability determinations for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). With 1634 status individuals deemed eligible for SSI by SSA are automatically enrolled in Medicaid.
Because of this rule, INDIVIDUALS WHO ARE 18 YEARS AND OLDER MUST APPLY FOR SOCIAL SECURITY TO MAINTAIN THEIR MEDICAID ELIGIBILITY STATUS. For those individuals who are transitioning from child to adulthood and receive an initial denial from SSA they may MAINTAIN their Medicaid during the appeals process.
How to contact Division of Family Resources Individuals can contact their local DFR office with questions or problems associated with their Medicaid State Health Plan. A map of local offices along with regional email addresses is available at: https://www.in.gov/fssa/files/DFR_Map_and_County_List.pdf
They may also call the member service line at: 1-800-457-4584
If the family member, individual, and/or you are unable to get a Medicaid issue resolved through DFR please call the local BDDS office who will work with the local DFR office to address the issue.