Indiana's Medicaid work requirements — now detailed by the state's Family and Social Services Administration (FSSA) — may affect adults enrolled in the Healthy Indiana Plan (HIP), the state's Medicaid expansion program for low-income adults ages 19–64. If you or someone in your household receives Medicaid through HIP, understanding these new rules is one of the most practical steps you can take right now to protect your health coverage.

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Data Snapshot

As of early 2025, Indiana had approximately 2.3 million Medicaid and CHIP enrollees, according to enrollment data published by the Centers for Medicare & Medicaid Services (CMS) at https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html. Under Medicaid expansion, Indiana's HIP program covers adults with incomes generally at or below 138% of the Federal Poverty Level (FPL). Nationally, the Kaiser Family Foundation has estimated that work requirement policies — depending on exemption design and administrative burden — could put hundreds of thousands of expansion enrollees at risk of coverage loss across implementing states. Indiana's own experience with a prior work requirement pilot offers a cautionary data point: administrative barriers, not unwillingness to work, have historically driven most disenrollments in similar programs.

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What Are Medicaid Work Requirements?

Medicaid work requirements — sometimes called "community engagement requirements" — are rules that require certain adult Medicaid enrollees to participate in qualifying activities for a set number of hours per month in order to maintain their coverage. These activities typically include:

  • Paid employment (full-time or part-time, including gig work)
  • Job search or job training programs
  • Vocational education or GED coursework
  • Community service or volunteer work with a recognized organization
  • Participation in an approved substance use disorder treatment program

Indiana's FSSA has outlined how these requirements would apply to HIP enrollees specifically. The rules are designed to align with federal guidance, but the details — including the number of required hours per month and the reporting procedures — are set at the state level and remain subject to federal CMS approval under a Section 1115 waiver.

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Who May Be Affected

Not every Medicaid enrollee in Indiana will be subject to work requirements. The FSSA rules include a range of exemptions. You may not be required to meet work requirements if you fall into one of the following categories:

Likely Exempt Groups

  • Individuals with a disability recognized under Medicaid, SSI, or SSDI criteria
  • Pregnant individuals and those within a defined postpartum period
  • Primary caregivers of a dependent child under a certain age, or of a person with a disability
  • Individuals with a serious medical condition documented by a licensed healthcare provider
  • Full-time students enrolled in an accredited educational program
  • Individuals aged 65 or older, or those under age 19
  • People experiencing homelessness, as defined under applicable federal guidelines
  • Individuals actively participating in a substance use disorder treatment program

This list reflects categories commonly recognized in state work requirement frameworks and in Indiana's FSSA guidance, but it is not exhaustive. Indiana's FSSA may recognize additional exemption categories as implementation details are finalized. If you believe you may fall into an exempt category, documenting your situation early — before any reporting deadline — is the most protective step you can take.

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What Qualifying Activities Look Like in Practice

For enrollees who are subject to the requirement, Indiana's rules are expected to require a minimum number of hours per month of qualifying activity. While the specific hour threshold is subject to finalization and federal approval, similar state programs have typically required 80 hours per month.

Activities you may be able to report as qualifying include:

  • Working at a job, including part-time or gig-economy work
  • Attending a workforce training or registered apprenticeship program
  • Participating in a SNAP Employment and Training (E&T) program
  • Volunteering with a recognized nonprofit or government agency
  • Enrolling in a community college course or vocational certification program
  • Participating in an approved job readiness or career preparation program

The critical factor is documentation. You will likely need to report your activities through an online portal or paper form provided by FSSA. Keeping organized records — pay stubs, employer letters, school enrollment confirmations, volunteer logs — will be essential to demonstrating compliance if your coverage is ever questioned.

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How to Protect Your Coverage: A Step-by-Step Checklist

Whether you believe you are exempt or subject to the requirement, taking these steps now may help you avoid an unexpected gap in health coverage.

Step 1: Confirm Your Current Enrollment Status Log in to Indiana's Medicaid portal at [https://www.in.gov/fssa/](https://www.in.gov/fssa/) or call the FSSA Division of Family Resources at 1-800-403-0864 to confirm you are currently enrolled in HIP and that your contact information is accurate and up to date.

Step 2: Update Your Mailing Address and Contact Information A significant number of enrollees lose coverage simply because they do not receive official notices. Make sure FSSA has your current mailing address, phone number, and email address on file. Notices about work requirements, exemption determinations, and reporting deadlines will be sent to the address FSSA has on record.

Step 3: Determine Whether You May Be Exempt Review the exemption categories listed above. If you believe you may qualify for an exemption, begin gathering supporting documentation now — before any deadline arrives:

  • Disability: SSI/SSDI award letter, or a signed letter from your treating physician
  • Caregiver status: Birth certificate of a dependent child, or documentation of a dependent's disability
  • Serious medical condition: A signed letter from your treating provider describing your condition and its functional limitations
  • Student status: An enrollment verification letter from your accredited school or program
  • Homelessness: Documentation from a shelter, outreach worker, or social services agency

Step 4: Understand the Reporting Process Before Deadlines Arrive FSSA is expected to provide an online reporting portal and paper-based alternatives for enrollees who cannot access the internet. Watch for official written communications from FSSA explaining how and when to report qualifying activities. Do not wait until a deadline is imminent to learn how the process works — processing delays and technical issues are common in new reporting systems.

Step 5: Connect With Local Assistance If You Need Help Navigating a new reporting requirement can be confusing, especially if you are managing a health condition or caregiving responsibilities. Indiana Legal Services ([https://www.indianalegalservices.org](https://www.indianalegalservices.org)) and local community action agencies may be able to provide free guidance on exemptions and appeals. You can also search for local assistance programs through Benefits.gov at https://www.benefits.gov.

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What Happens If You Don't Meet the Requirements

If you are subject to work requirements and fail to report qualifying activities — or fail to claim and document an exemption — Indiana's rules may result in a suspension or termination of your Medicaid coverage. This is not typically immediate or automatic; most frameworks include a notice period and an opportunity to respond before any action is finalized.

If you receive a notice that your coverage is being suspended or terminated, you generally have the right to:

  • Request a fair hearing to appeal the decision and present your case
  • Submit documentation showing that you were exempt or did meet the requirements during the relevant period
  • Reapply for coverage if your circumstances change or if you are later able to demonstrate compliance or exemption

Do not ignore any official correspondence from FSSA. Even if you are confident you are exempt, failing to respond to a notice can result in a coverage loss that takes time and effort to reverse — and a gap in coverage can have real consequences for your health and finances.

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The Broader Policy Context

Indiana is among a growing number of states pursuing Medicaid work requirements under Section 1115 waiver authority, which allows states to test new approaches to Medicaid program design with federal approval from CMS. The legal and regulatory landscape around these requirements has shifted considerably in recent years — federal courts previously blocked similar requirements in Arkansas and other states, and the Biden administration rescinded several approved waivers. The current federal administration has signaled renewed support for state work requirement proposals.

This means the timeline and final form of Indiana's requirements may still evolve before full implementation. Staying informed through official FSSA communications and trusted policy sources such as the Center on Budget and Policy Priorities ([https://www.cbpp.org](https://www.cbpp.org)) can help you track any changes that may affect your coverage before they take effect.

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Documents to Gather Now

Regardless of your specific situation, having these documents organized and accessible may help you respond quickly to any FSSA request or notice:

  • Photo ID (driver's license, state-issued ID, or passport)
  • Proof of Indiana residency (utility bill, lease agreement, or official mail)
  • Proof of income (recent pay stubs, employer letter, or self-employment records)
  • Social Security number or documentation of immigration status
  • Medical documentation if you plan to claim a health-related exemption
  • Proof of school or training enrollment if applicable
  • Caregiver documentation if you are caring for a child or a dependent adult with a disability

Having these materials ready before any deadline means you are not scrambling to gather paperwork under pressure — and it gives you the best chance of a smooth interaction with FSSA if questions arise about your coverage.

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Last reviewed: July 2025