Presumptive Eligibility

The Indiana Health Coverage Programs (IHCP) includes three authorized processes - Presumptive Eligibility for Pregnant Women (PEPW), Hospital Presumptive Eligibility (Hospital PE), and Presumptive Eligibility (PE) - by which individuals can be determined presumptively eligible and receive temporary health coverage until the Family and Social Services Administration (FSSA) determines official eligibility. The following table describes the most significant differences between the three processes.

Special note: For information about the PE process for inmates, see Presumptive Eligibility for Inmates.

Presumptive eligibility table 3

*Acute care hospitals now enrolled as PEPW qualified providers (QPs) retain their ability to determine presumptive eligibility for pregnant women under the PEPW process; however, no new acute care hospitals will be enrolled as PEPW QPs. Going forward, acute care hospitals will be enrolled as qualified providers under Hospital PE.

Select the following links for more information: