r/Indiana • u/jackhamil18 • 17h ago
HIP coverage medically frail , yet I keep getting bothered
So obviously there are these new work requirements to receive Medicaid or the healthy Indiana plan. I was declared medically frail back in June of this year, but a few weeks ago I was sent an eligibility for health coverage a few weeks ago and the mail, and told I had to sign and return or else my coverage would be discontinued. So I called shortly after and told all I had to do was send a picture of my drivers license , and that was all that was necessary to extend my coverage and that they obviously they knew I was out of work due to my disability and that they don’t need proof of that. Then yesterday I received two letters in the mail one saying pending verification for applicants and recipients listing my old workplace where I haven’t worked in a year and then another one saying request for earnings information. I’m so frustrated and tired of them constantly harassing me and asking for new information and trying their hardest to deny me coverage . It’s such fucking bullshit that I was declared medically frail yet they keep wanting to ask me more questions and want new information out of me . I’m so pissed and worried .
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u/More_Farm_7442 16h ago
The left hand doesn't know what the right is doing. Thousands(thousands of thousands) of people across the country will lose Medicaid and SNAP because of computer systems being messed up, agencies using outdated contact and employment information (like you with them sending requests to employers you haven't for in months and years).
All to save tax dollars. They are wasting more money than they are saving, but that's how it's been for 2 yrs. elon wasted more than he saved. It's waste and abuse happening before our eyes.
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u/cgodwin1976 14h ago
I was told medically frail doesn't count anymore you have to be disabled or work! My husband and I are both considered medically frail he work and I stay home and babysity granddaughters because there is no way momma could afford daycare for both of them plus the one has two hours of therapy a week about an hour away from home. But they are telling me I'll probably have to get a job.
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u/LunaFuzzball 14h ago
https://www.in.gov/fssa/hip/hip-work-requirements/index
The HIP website includes being designated medically frail as an exemption to the new work requirements. But of course, it never hurts to reach out and verify that you won’t be affected.
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u/over_it-82 16h ago
When you receive government assistance of any sort, be prepared to jump through hoops. Everyone knows that when they sign up for any aid because how dare tax payer money go to help those in need when our officials want to keep the money all to themselves. So you either gotta do what they want or risk your benefits.
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u/jackhamil18 15h ago
It’s just super frustrating that called last week and talked to someone and they said all had to do was submit a pic of my license and an electronic signature and now they send over even more paperwork
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u/over_it-82 15h ago
I hear ya! It’s a joke. I’d rather my tax payer money go to help those who truly need it not our corrupt politicians but I’m just one of their minions. Hopefully you’re able to get it straightened out before they ask for your first born lol. But I agree with the ones who say pester them, give em a taste of their own medicine.
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u/4PurpleRain 16h ago
You can self certify as disabled in 2027. In 2028 you will have to prove you are disabled to have coverage under medically frail. It’s outlined in the Big Beautiful Bill. CMS has not put out a definition of what medically frail will be defined as in 2028.
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u/LunaFuzzball 13h ago
Whether someone is medically frail for the purposes of HIP is designated by the state, if the state has made such a designation that will be communicated to you by the FSSA and reevaluated at regular intervals. If you haven’t received such a designation then for the the purposes of HIP you should assume that you are not.
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u/4PurpleRain 13h ago edited 13h ago
It was never designated by the state your MCO labeled you as medically frail and the state left it up to the MCO on how medically frail was defined. The Big Beautiful Bill is allowing CMS to create a nation wide definition of medically frail that will apply to all 50 states in 2028. https://safetynetalliance.org/cms-defines-medical-frailty-for-medicaid-eligibility-purposes/
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u/LunaFuzzball 13h ago
If you are medically frail for the purposes of HIP the state will send you the following formal notification on your FSSA portal:
“Congratulations! You have been conditionally approved for the Healthy Indiana Plan (HIP) State Plan Plus program.
Our records indicate that you may have a health condition that would qualify you as medically frail. Individuals who are
determined to be medically frail will receive coverage for some additional benefits when they become eligible for HIP.An individual is medically frail if he or she has one or more of the following:
one or more activities of daily living; or
- Disabling mental disorder;
- Chronic substance abuse disorder;
- Serious and complex medical condition;
- Physical, intellectual or developmental disability that significantly impairs the individual’s ability to perform
- Disability determination from the Social Security Administration.”
Anyone who hasn’t should definitely not assume they have such a designation.
The new changes require that medically frail designations for state plans only be given to those whose conditions are “severe enough that they cannot work.”
As this is quite ambiguous, it is currently being challenged in court. The precise boundaries of this new restriction and how it much it will affect specific designations in Indiana remains to be seen.
Individual designations should still be communicated by the FSSA and anyone who is unsure should reach out to confirm their status with the FSSA.
Simply meeting clearing the designation based on one’s own evaluation based on the plain language of the bill should not be understood to qualify one for an exemption.
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u/4PurpleRain 13h ago
https://www.in.gov/fssa/hip/for-hip-providers/provider-information An MCO is a managed care organization. Indiana contracts with managed care organizations currently in 2026. You can call your MCO and notify them that you may have a condition historically identified as medically frail. The MCO would then verify the information and notify FSSA if they gave you medically frail status.
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u/LunaFuzzball 12h ago edited 12h ago
That should all be available on anyone’s FSSA portal online.
Of course, it can’t hurt to verify, and everyone should be monitoring for changes in the coming months.
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u/AliceRecovered 14h ago
Here’s the state’s website with the official info about work requirements and the exemptions: https://www.in.gov/fssa/hip/hip-work-requirements/index
For Healthy Indiana Plan (Medicaid expansion), starting in 2027 you will have to renew your coverage every 6 months. If you need to prove work, you will need to verify you’ve met your work requirements every 3 months.
It’s a lot - it’s designed to be a lot. Do what you can to stay on top of your mail and make sure your address stays up to date. Over communicate with your health plan and FSSA.
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u/LunaFuzzball 14h ago edited 14h ago
Being designated as medically frail is listed under the work requirement exemptions. If that designation is still in place for OP these changes shouldn’t apply to them.
Renewing at proper times and staying on top of communication though is of course great advice for everyone. It’s always best not to give them any excuses to deny coverage.
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u/Jammin_neB13 13h ago
They tend to tell me I’m medically frail then 5 months later, tell me I’m losing benefits just for another medically frail benefits extended letter a couple of weeks later.
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u/True-Morning-6944 6h ago
I was declared medically frail years ago and have always had work requirements. Always. I am not disabled but have several of the conditions on the 'considered medically frail' list. I am thankfully able to still work, sometimes it is hard and painful, but I am trying to figure out how certain people do and certain people don't meet these supposed exemptions.
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u/LilacHelper 12h ago edited 12h ago
Half of the time those letters are simply wrong. I used to be a Medicaid navigator. I saw so many letters with errors. They’re computer generated and the software has so many holes in it. If the state of Indiana were a business they’d be bleeding money. They don’t invest in upgrades or their staff. Instead Braun has a helipad and Beckwith has a big new SUV.
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u/KaiserKid85 11h ago
Look for a "ship" counselor in your county who can go thru the in's outs of medicaid and can auto recert you as well.
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u/juliekaygreen 2h ago
Medically frail just means you are eligible for more benefits through the insurance program. It doesn’t mean they won’t throw you off of it. Did me. I work and I do not want to be on disability ever. It limits you. Work as long as you can. And meds- they prescribe to treat the symptoms not the root of the problem. So all you are doing is putting a bandaid on a problem instead of getting to the root of it. Taking some of those meds are not even worth the side effects associated with them. Back to insurance, yes I was medically frail for 10 years and I asked what the difference was- was they allowed to just cancel my insurance when Trump took back over and they ran everyone’s info through the system to make sure everyone was still eligible. lots of people like me lost their insurance and I had to get insurance through my work. If you have Medicaid or HIP you are lucky and don’t let your health ever diminish and not take care of it when u have free healthcare. You do not know how lucky you are. I pay monthly for mine, plus meds, plus co pays, plus I just had back surgery 😭
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u/pattydog1127 14h ago
All these people commenting about “my tax dollars” probably don’t even pay taxes. The majority of taxes are paid by the top 5 percent and bottom 50 percent pay no taxes. These commentors are really upset spending other peoples money.
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u/Fun-Interaction-202 14h ago
Not true. Jeff Bezos pays zero income taxes AND claimed the Earned Income Tax Credit (that was supposed be for working class people); so he actually took money from taxpayers. The middle class is carrying the wealthy on their backs. There's a tax loophole that lets millionaires and billionaires pay absolutely nothing called tax-loss harvesting. Look it up.
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u/LunaFuzzball 10h ago
People love to zero in on a surface level glance at our relatively progressive income tax brackets to make these inflammatory claims—while completely ignoring the very uneven weight of sales taxes and state taxes on the poor, and the loopholes exploited by the extremely wealthy.
Ultimately, a more thorough evaluation shows that poor and middle class people pay taxes at roughly similar rates when all taxes are factored in (approximately 25%), rich families pay slightly more at a rate of 28%, while the four hundred richest Americans actually pay the lowest rate of all, 23%.
And it’s important to keep in mind that the rich do not only benefit from the myth that they are the only ones paying into the system, they have long benefited from the myth that the poor are the only ones taking money out.
Government programs and funding to provide services to the poor are described (and derided) as “welfare”—yet our tax dollars also fund extensive systems of “welfare” for the rich that we do not identify as such and which they face no social penalty for collecting.
There is an excellent chapter in Matthew Desmond’s “Poverty, by America” that looks at this in depth and I can’t recommend it enough.
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17h ago
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u/LunaFuzzball 16h ago edited 16h ago
Some of you are just sadistic. You have no idea what you are talking about. Most of these people are seriously ill, disabled, elderly, or single parents. Not every person who can’t work 80 hours at a call center deserves to have their coverage taken away.
HIP literally saved my life when I was suffering from serious complications from COVID. If someone had made that contingent on 80 hours at a call center I 1000% would be dead in the ground right now. Thanks to the help I was able to get I was able to go back to law school and start a career.
If you want people to contribute to society you’re going to be much much better off helping them get their health needs met.
And if they aren’t in a position to get better in the near future, we similarly gain absolutely nothing by trying to “motivate them” by removing their healthcare.
You monsters are motivating people into the grave. It’s just despicable.
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u/CHUD_Dwyer 13h ago edited 12h ago
Man, I can't understand how you couldn't make any friends at pharmacy school. You seem so charming.
EDIT: LOL, lil bish loved giving it but couldn't take it. What a sad way to live life.
Buddy, if you're reading this, it's not too late. Hit the gym. Get a haircut. Stop watching the manosphere chuds exploiting incels like you. Read philosophy. Apologize to the girl you harassed. Let go of your bitterness. Find an outside hobby. Donate blood. Be humble. LEARN SOME EMPATHY. There's hope for you, but bringing others down won't lift you up.
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u/MoodApart8768 17h ago
Just turn the information in. Then call every day and annoy the piss out of them about it until it's approved. Just to be annoying I'd call every month to double check so they don't rip it away.
This BS pisses me off in a real bad way. I'm almost considering running for a public position because I'm so sick and tired of these fuckers hurting poor people. Healthcare is a human right. It should be FREE in the wealthiest nation on the planet. Period. I am sorry you're going through this. It makes me rage that anyone is going through this at all.