Home > Benefits > Change > Life Events Changes > Medicaid/Medicare

Medicaid or Medicare Eligibility

A change in eligibility for Medicaid, Medicare, or other federal/state agency benefits will allow you to make changes to your benefit plans outside of Open Enrollment. You must make the change within 60 days of becoming eligible for Medicaid and within 30 days of becoming eligible for Medicare. The eligibility change can be experienced by the employee, spouse, or dependent.

Documentation

Accepted Documentation for Gain of Medicaid or Medicare Eligibility:

  • Statement of benefits that outlines the coverages (i.e., medical/dental/vision), enrollee(s), and effective start date of coverage.
  • Government-issued letter or statement that you/your dependents are newly eligible for state-sponsored coverage.

Accepted Documentation for Loss of Medicaid or Medicare Eligibility:

  • Government-issued letter or statement that you/your dependents are no longer eligible for state-sponsored coverage.

In addition, when newly adding a spouse and/or dependent(s) due to loss of non-IU coverage, dependent documentation (i.e. marriage certificate, birth certificate, etc.) must be submitted.

Medical and Dental Coverage

You may take the following actions:

  • Add or discontinue coverage for the affected individual(s) (yourself, your spouse, or dependents).
  • Enroll in or drop coverage if the employee had the change in eligibility.

Flexible Spending Accounts (FSA)

You may take the following actions. The action must be consistent with the qualifying event.

  • Enroll in a Healthcare Spending Account.
  • Increase or decrease your Healthcare Spending Account election (if already enrolled).

Health Savings Account (HSA)

If you enroll in a High Deductible Health Plan (HDHP) you are also eligible to enroll in a Health Savings Account (HSA). Once enrolled, you may change your contribution amount at any time by completing an HSA Enrollment/Change form.

IRS regulations regarding HSAs stipulate that if you are enrolled in a government-sponsored medical benefit you are ineligible to make or receive tax-free contributions to an HSA.

NOTE: if you enroll in the HSA or change your HDHP coverage level on or after September 1, you will not receive IU’s contribution to your HSA for the remainder of the calendar year.

Resources

Make Benefit Changes