MedicaidAdministrativeMedium impact
BT202461: Medicaid cost sharing restarts July 1, 2024
Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid is restarting cost-sharing requirements on July 1, 2024, for CHIP (Package C) and MEDWorks programs after a 4-year pause due to COVID-19. Patients will need to pay copayments ($3-10 for prescriptions, $10 for ambulance) and monthly premiums ($22-254 based on income), with providers unable to refuse service for inability to pay except pharmacists.
Action Required
By July 1, 2024: Front desk staff must update patient collection procedures for Indiana Medicaid CHIP and MEDWorks members to collect copayments ($3-10 for prescriptions, $10 for ambulance services). Train staff that service cannot be refused if patient cannot pay at time of service. Update billing system to track 5% out-of-pocket maximum for these members. Pharmacy staff may refuse to fill prescriptions if copayment cannot be paid.