MedicaidAdministrativeHigh impact
BT202574: IHCP announces updates to the PE application process regarding Medicare coverage
Indiana Medicaid (IHCP)·IN·Medical Policy
Effective date
Jul 30, 2025
We identified it
Jun 18, 2026
Summary
Starting July 30, 2025, IHCP will automatically check if applicants have active Medicare Part A or B when providers submit Presumptive Eligibility applications, and will deny all PE applications for members with Medicare coverage. Providers must verify Medicare status in the Other Insurance Details section before submitting to avoid denials.
Action Required
By July 30, 2025: Front desk staff must check the Other Insurance Details section in the IHCP Portal for active Medicare coverage before submitting any Presumptive Eligibility applications. Update PE application workflow to include mandatory Medicare verification step. If member has Medicare Part A or B, do not submit PE application as it will be automatically denied. For wrongful denials, contact PresumptiveEligibility@fssa.in.gov.