Indiana’s Family and Social Services Administration estimates that more than 58,000 Healthy Indiana Plan members are not yet meeting the state’s new work rules, which call for 80 hours a month of work, school or other approved activity. The rules start with applications and renewals begun on or after January 1, 2027. A member with no qualifying hours and no exemption gets a Notice of Non-Compliance, and coverage stops if proof never arrives.
What the 58,000 estimate counts
The Family and Social Services Administration, known as FSSA, put out the number on October 5, 2026. Its announcement says FSSA “estimates that over 58,000 HIP members are currently not in compliance with pending HIP Work Requirements.”
The figure covers members who may not meet the requirements or qualify for an exemption, drawn from the most recent data available. It is an estimate of exposure, not a count of lost coverage. The rules have not started, so no one has yet been dropped for missing them.
The estimate was released 88 days before the January 1 start. It also sits beside the more than 500,000 notifications FSSA reports sending, which means the outreach reached far more people than the group the agency flags as not yet compliant.
FSSA says its public outreach began in June 2026. The agency reports notifications to more than 500,000 HIP members, partner messages, social media posts, listserv alerts and eight in-person town halls across Indiana, with more planned.
80 hours, $580 or an exemption
The rules apply to HIP adults ages 19 to 64 who are not pregnant and are not enrolled in or eligible for Medicare. A member in that group should find out now whether work, school or an exemption already adds up for each month.
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Eighty hours a month can come from employment, volunteering, a work program, an apprenticeship, or school at least half-time. The hours can be combined, so a part-time job plus volunteer shifts can reach the total.
Income is an alternative measure. Earning at least $580 a month also meets the rule, which FSSA says equals the federal minimum wage of $7.25 times 80 hours. Seasonal workers can average $580 a month over the prior six months.
To convert pay into hours, FSSA says to divide gross monthly income by $7.25. Its example is $507.50, which equals 70 hours. Paid time off counts toward income. Unpaid time off does not.
Exemptions that count for the whole month
A member is exempt for a month if any listed condition applies on at least one day of it. The list includes being under 26 and formerly in foster care, belonging to a federally recognized Tribe, and being a parent or caregiver of a child 13 or younger. Caregivers of a person with a disability and veterans with a 100 percent disability rating are also on it.
Pregnancy, or up to 12 months after it ends, qualifies. So does incarceration or release within the past 90 days, following SNAP or TANF work rules, or being in a drug or alcohol treatment program. FSSA adds that other exemptions may apply.
The medically frail category is the least settled. The state decides who qualifies, and clinicians may recommend. FSSA says it is still working with the Centers for Medicare & Medicaid Services on criteria, including that a condition significantly impairs the person’s ability to comply, and more guidance is expected. The state’s member guidance says no separate notice goes out when frail status is not met.
Lookback months and the six-month renewal clock
HIP renews every six months, and FSSA says the state checks compliance every three months. If hours or an exemption cannot be confirmed, the state sends a notice asking for proof.
Each check looks back three months before the renewal month or quarterly review. A May renewal looks back to February, March and April. For someone applying in January, the months that count are October, November and December, so hours worked this fall already matter.
Changes in work, school, health or family are due within 10 days. Members can report through the Benefits Portal at FSSABenefits.IN.gov, by phone at 1-800-403-0864, by mail to the FSSA Document Center in Marion or at a local Division of Family Resources office. The portal lists each household’s redetermination date.
FSSA’s steps for members start with reviewing the requirements at myfssa.in.gov, creating a Benefits Portal account and using the pre-screening tool to see whether the rules apply. Questions go to 1-800-457-8283 by phone or 1-888-311-1846 by text. A household’s redetermination date may differ from another member’s and may change, and the state says it will send notice when it does.
What follows a Notice of Non-Compliance
A member who has neither qualifying activity nor an exemption gets a Notice of Non-Compliance. Coverage then stops and the person must reapply. During that time the person also cannot get Marketplace financial help.
FSSA has not published a cure period or a way to restore coverage without reapplying. For the 58,000, the question is whether a proof of hours, a medical-frailty determination or an exemption can be in place before the first January check.
Can a HIP household show 80 hours by January?
A Healthy Indiana Plan member whose hours or exemption cannot be proved in the lookback months gets a notice, and coverage then stops until the person reapplies. FSSA has published no way to restore coverage without a new application.
The SNAP & Medicaid Renewal Organizer covers the new Medicaid work requirement and who is exempt, and its Part 6 is built around that rule. It also includes a renewal and reporting calendar and a renewal document checklist for keeping proof in one place.
Get the Medicaid work-rule exemptions and renewal calendar in the renewal organizer →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
