Indiana § 12-15-44.5-3 Establishment of plan; eligibility; oversight of marketing; promotion of
plan; distribution of enrollment; standards for consumer protection;
exemptions

Indiana Statutes

§ 12-15-44.5-3 — Establishment of plan; eligibility; oversight of marketing; promotion of plan; distribution of enrollment; standards for consumer protection; exemptions

Indiana § 12-15-44.5-3

Art. 15MEDICAID

Ch. 44.5Healthy Indiana Plan 2.0

This text of Indiana § 12-15-44.5-3 (Establishment of plan; eligibility; oversight of marketing; promotion of plan; distribution of enrollment; standards for consumer protection; exemptions) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 12-15-44.5-3 (2026).

Text

(a)The healthy Indiana plan is established.

(b)The office shall administer the plan.

(c)The adult group described in 42 CFR 435.119 may be eligible for the plan if the conditions in section 4 of this chapter are met and if the individual meets at least one (1) of the following:

(1)Is working at least twenty (20) hours per week on a monthly average.

(2)Is participating in and complying with the requirements of a work program for at least twenty (20) hours per week, as determined by the office.

(3)Is volunteering at least twenty (20) hours per week, as determined by the office.

(4)Undertakes a combination of the activities described in subdivision (1), (2), or (3) for a combined total of at least twenty

(20)hours per week, as determined by the office.

(5)Participates in and complies

Free access — add to your briefcase to read the full text and ask questions with AI

(a) The healthy Indiana plan is established.
(b) The office shall administer the plan.
(c) The adult group described in 42 CFR 435.119 may be eligible
for the plan if the conditions in section 4 of this chapter are met and if
the individual meets at least one (1) of the following:
(1) Is working at least twenty (20) hours per week on a monthly
average.
(2) Is participating in and complying with the requirements of a
work program for at least twenty (20) hours per week, as
determined by the office.
(3) Is volunteering at least twenty (20) hours per week, as
determined by the office.
(4) Undertakes a combination of the activities described in
subdivision (1), (2), or (3) for a combined total of at least twenty
(20) hours per week, as determined by the office.
(5) Participates in and complies with the requirements of a
workfare program, as determined by the office.
(6) Receives unemployment compensation and complies with
federal and state work requirements under the unemployment
compensation system.
(7) Participates in a substance use treatment and rehabilitation
program.
(8) Is medically certified as physically or mentally unfit for
employment.
(9) Is pregnant or is a parent or caretaker responsible for the care
of a dependent child less than six (6) years of age.
(10) Is a parent, spouse, or caretaker personally providing the care
for an individual with a serious medical condition or a disability.
(11) Is an individual who has been released from incarceration for
less than ninety (90) days.
(12) Is an Indiana resident enrolled in and attending an accredited
educational program full time.
An individual must meet the Medicaid residency requirements under
IC 12-15-4-4 and this article to be eligible for the plan.
(d) The following individuals are not eligible for the plan:
(1) An individual who participates in the federal Medicare
program (42 U.S.C. 1395 et seq.).
(2) An individual who is otherwise eligible and enrolled for
medical assistance.
(e) The department of insurance and the office of the secretary shall
provide oversight of the marketing practices of the plan.
(f) The office shall promote the plan and provide information to
potential eligible individuals who live in medically underserved rural
areas of Indiana.
(g) The office shall, to the extent possible, ensure that enrollment in
the plan is distributed throughout Indiana in proportion to the number
of individuals throughout Indiana who are eligible for participation in
the plan.
(h) The office shall establish standards for consumer protection,
including the following:
(1) Quality of care standards.
(2) A uniform process for participant grievances and appeals.
(3) Standardized reporting concerning provider performance,
consumer experience, and cost.
(i) A health care provider that provides care to an individual who
receives health coverage under the plan shall also participate in the
Medicaid program under this article.
(j) The following do not apply to the plan:
(1) IC 12-15-12.
(2) IC 12-15-13.
(3) IC 12-15-14.
(4) IC 12-15-15.
(5) IC 12-15-21.
(6) IC 12-15-26.
(7) IC 12-15-31.1.
(8) IC 12-15-34.
(9) IC 12-15-35.
(10) IC 16-42-22-10.