Losing Medicaid in Indiana in 2026 usually means losing the Healthy Indiana Plan (HIP), the state's Medicaid program for adults ages 19 to 64 with income up to 138% of the federal poverty level. Indiana expanded Medicaid through HIP in 2015, and the Family and Social Services Administration (FSSA) runs it. HIP membership has fallen sharply since 2025, from roughly 671,000 members at the April 2025 bill signing to about 487,000 by June 2026, according to Indiana news reporting on FSSA data. Coverage ends for many reasons: an unreturned renewal packet, income that rose above 138% FPL, a missed POWER account contribution, or a change in household status. Federal rules treat the loss as a qualifying life event, so a 90-day Marketplace Special Enrollment Period opens on healthcare.gov the day coverage ends. The SEP does not erase your right to dispute the decision. You can appeal to FSSA and enroll in a Marketplace plan during the same weeks, which protects you whichever way the appeal turns out.
Indiana routes Marketplace enrollment through the federal platform at healthcare.gov, unlike states that run their own exchange, so the Medicaid system and the Marketplace are two separate applications. Medicaid applications, renewals, and appeals go through the FSSA Benefits Portal or the FSSA Division of Family Resources line at 800-403-0864. Marketplace plans come from healthcare.gov or a licensed Indiana navigator. Timing matters more in late 2026 than in most years. The 2027 ACA Open Enrollment Period opens November 1, 2026, and federal changes enacted in 2025 add work requirements and six-month renewals for expansion adults starting in 2027. Enhanced premium tax credits expired January 1, 2026, so the 400% FPL subsidy cliff is back. Check the Medicaid income limits, ACA income limits, and federal poverty level pages for the exact lines, then use the 7 steps below to protect your coverage. Hoosiers who lose HIP also keep access to free help: licensed navigators and certified application counselors can walk through both the FSSA appeal and the healthcare.gov application at no cost.
7 Steps to Get Coverage
Common Mistakes That Cost People Thousands
Hoosiers who lose Medicaid in 2026 most often make these five mistakes:
- Waiting for the appeal result before enrolling in a Marketplace plan. The 90-day SEP keeps running during an appeal, and a slow hearing can use up the window. Enroll in a healthcare.gov plan as a backup and cancel it if the appeal wins.
- Missing the 33-day Indiana appeal deadline. FSSA hearing requests filed after 33 days from the notice date risk dismissal, and filing after the termination effective date means benefits do not continue while you wait.
- Using 2025 tax-return income instead of projected 2026 income. Marketplace credits follow your expected 2026 income, so a mid-year drop in pay can raise your subsidy and a raise can shrink it.
- Assuming everyone in the family lost coverage together. Children often still qualify for Hoosier Healthwise or CHIP up to about 250% FPL even when a parent moves to a Marketplace plan. Check each person separately.
- Skipping the first premium payment. A selected healthcare.gov plan does not start until the insurer receives payment, so completing enrollment without paying leaves you uninsured.
Why Indiana Medicaid Coverage Ends in 2026 and What Each Reason Means
Indiana Medicaid terminations in 2026 fall into three groups, and the group decides your best next step. Procedural terminations happen when FSSA cannot verify information, such as an unreturned renewal packet or a returned envelope, even though the member may still qualify. Income terminations happen when FSSA data from employers, the IRS, or the Social Security Administration shows income above 138% FPL ($22,025 for one person in 2026). HIP-specific terminations happen when a member misses a POWER account contribution, which can move coverage to HIP Basic or end it for higher earners. Procedural terminations are the strongest appeal candidates because the fix is often just supplying the missing document. Income terminations point toward a healthcare.gov plan with premium tax credits. Read the reason code on your notice before choosing a path. Keep every envelope and portal message from FSSA, because the dates on those items fix your deadlines.
Federal rules classify loss of Medicaid or CHIP as a qualifying life event for a 90-day Marketplace Special Enrollment Period, longer than the 60-day SEP for most other events, according to healthcare.gov. The notice itself is your proof, and the SEP applies whether coverage ended by termination or by an appeal you later lost. Looking ahead to 2027, federal law enacted in 2025 requires states to verify work or community engagement for expansion adults and to renew coverage every six months. Indiana's own HIP rules add an 80-hour monthly standard. Adults denied Medicaid for failing a work requirement are expected to lose access to Marketplace premium tax credits as well, so documenting an exemption early matters more than relying on the Marketplace as a fallback.
Medicaid Income Limits and ACA Subsidy Lines in Indiana for 2026
Indiana's 2026 income ladder has three rungs. Adults ages 19 to 64 qualify for HIP at or below 138% of the federal poverty level, which is $22,025 for one person and $45,540 for a family of four in 2026 under the HHS ASPE poverty guidelines. Between 138% and 400% FPL, adults qualify for premium tax credits on healthcare.gov plans, and the credit shrinks as income rises. Above 400% FPL ($63,840 for one person, $132,000 for a family of four in 2026), the subsidy cliff applies because the enhanced credits from the American Rescue Plan and Inflation Reduction Act expired January 1, 2026. Silver plans add cost-sharing reductions up to 250% FPL ($39,900 for one person in 2026), which can cut deductibles from several thousand dollars to under $1,500. The 2026 out-of-pocket maximum is $10,600 for one person and $21,200 for a family. Compare against the Medicaid income limits page and the ACA income limits page before deciding. Use the screener on this site for a quick estimate of which rung you sit on.
Documents and Timing: Appeal and Marketplace Enrollment at the Same Time in Indiana
Running the FSSA appeal and the healthcare.gov application in parallel works because the two systems do not talk to each other. FSSA reviews your Medicaid case, and healthcare.gov only needs the termination notice to open the 90-day SEP. If the appeal wins, Medicaid is reinstated and you cancel the Marketplace plan. If the appeal loses, the Marketplace plan is already active. Gather the FSSA notice, 2026 income proof, Social Security numbers, and proof of Indiana residence once and use them for both applications. Enrolling before the last day of the month starts coverage on the first of the following month, and the SEP end date is counted in calendar days from the Medicaid end date, so mark both on a calendar the day the notice arrives. Call the Marketplace at 1-800-318-2596 if the SEP option does not appear.
Frequently Asked Questions
How long do I have to enroll in a Marketplace plan after losing Indiana Medicaid?
You have 90 days from the date your Indiana Medicaid ends to enroll in a healthcare.gov plan through the loss-of-Medicaid Special Enrollment Period. If coverage ends October 31, 2026, the window runs November 1, 2026 through January 29, 2027. That window overlaps the 2027 Open Enrollment Period, which runs November 1, 2026 to January 15, 2027, so you can choose a 2027 plan either way. Missing both windows leaves you uninsured until another qualifying life event. Medicaid itself has no deadline in Indiana, so you can reapply year-round if your income is at or below 138% FPL ($22,025 for one person in 2026).
What documents do I need to prove I lost Indiana Medicaid?
Your FSSA termination or denial notice is the key document, because it shows the coverage end date and proves the qualifying life event for the Marketplace SEP. Healthcare.gov may ask you to upload it within about 30 days of enrolling. Also gather Social Security numbers for everyone applying, proof of Indiana residence, and projected 2026 income proof such as pay stubs, an unemployment award letter, or a self-employment estimate. Add immigration documents for non-citizen household members and birth certificates for children. Keep copies of everything you submit to both FSSA and healthcare.gov in case a reviewer asks again.
What happens if I miss the 90-day SEP after losing Indiana Medicaid?
Missing the 90-day Special Enrollment Period means you generally wait for the next ACA Open Enrollment Period, which opens November 1, 2026 for 2027 coverage and ends January 15, 2027. Coverage that starts through Open Enrollment begins no earlier than January 1, 2027, so the gap can last months without insurance and without protection from large bills. Another qualifying life event, such as marriage, a birth, or a move, can open a new SEP. Medicaid and Hoosier Healthwise or CHIP for children stay open year-round, so reapply to FSSA at once if your 2026 income is at or below 138% FPL.
Can I get retroactive coverage after losing Indiana Medicaid?
A won appeal can restore Medicaid retroactively to the termination date, which closes any gap. A new Medicaid application can also cover recent medical bills in some cases, so ask FSSA about retroactive eligibility when you reapply. Marketplace coverage is not retroactive under the loss-of-Medicaid SEP. A plan chosen in the SEP starts the first of the month after you select it, so choosing a plan before the end of the month your Medicaid ends keeps the gap short. Enroll early, pay the first premium promptly, and keep the confirmation. Cancel the Marketplace plan only after FSSA confirms reinstatement in writing.
What is the difference between COBRA and a Marketplace plan after losing Medicaid?
COBRA applies only if you also had employer group coverage that recently ended, and it costs 102% of the full premium, roughly $400 to $900 a month for one adult and $1,200 to $2,800 for a family in 2026. A healthcare.gov plan with premium tax credits often costs $10 to $200 a month for incomes between 138% and 250% FPL. Choose COBRA mainly to keep a specific specialist or protect a deductible already met in 2026. Your COBRA election window is separate from the 90-day Marketplace SEP, so compare both before either window closes.
What Indiana-specific rules apply when Medicaid ends?
Indiana uses healthcare.gov for Marketplace plans, and FSSA runs Medicaid, including the Healthy Indiana Plan (HIP), Hoosier Healthwise, and CHIP. You have 33 days from the notice date to request a state hearing, and filing before the termination date keeps benefits during the appeal, except for terminations tied to missed POWER account payments. FSSA begins phasing in HIP work requirements of 80 hours a month in January 2027, so check exemptions now. Call the FSSA Division of Family Resources line at 800-403-0864 or use the FSSA Benefits Portal for appeals, renewals, and new applications.
Do I still qualify for Indiana Medicaid after the termination?
You still qualify for HIP if you are ages 19 to 64, an Indiana resident, and your 2026 household income is at or below 138% FPL: $22,025 for one person, $29,863 for two, $37,702 for three, and $45,540 for four. Procedural terminations for missing paperwork are common, so supply the missing document and reapply or appeal. Above 138% FPL you move to premium tax credits on healthcare.gov up to 400% FPL ($63,840 for one person in 2026). Pregnant women and children qualify at higher income levels, so check those categories separately.
What happens to my children's coverage if my Medicaid ends?
Children keep a separate path. Hoosier Healthwise and CHIP cover Indiana children in households with incomes up to about 250% FPL in 2026 (roughly $82,500 for a family of four; confirm the exact limit with FSSA), and enrollment is open year-round. A parent losing HIP does not automatically end a child's coverage, but renewal notices can be sent to the same address, so check your FSSA Benefits Portal account for each child. If your children lost coverage too, apply for them through FSSA while you enroll yourself in a healthcare.gov plan. Families sometimes choose one Marketplace family plan, but compare it against low-cost CHIP coverage first.
