Check Member Eligibility

Th e Indiana Department of Families and Children (IDFC) determines a person’s eligibility for Hoosier Healthwise. 

To verify member eligibility, providers can:

• Call the EDS automated voice response (AVR) system. EDS, Indiana’s fiscal agent for Medicaid, has an AVR system that can be reached 24 hours a day from any touch tone phone. Just call 1-800-738-6770 and follow the menu prompts.
• Log onto the EDS Web interChange . You may inquire about eligibility by the member’s Hoosier Health ID number, social security number, or name and date of birth.
• Use an OMNI 380 terminal, usually referred to as an OMNI swipe card device, to run the patient’s Hoosier Health ID card. Note: EDS can no longer provider new terminals, but technical support for existing terminals is available by calling 1-800-284-3548.
• Submit fax requests to our provider service center at 1-877-725-4547.
• Call our provider service center. If you cannot confirm a member’s eligibility with the above methods, please call our provider service center at 1-866-930-0017. Select the options to verify eligibility. Please have the member’s name and Hoosier Health ID number ready.

Newborn Enrollment

Newborns whose mothers are members of CareSource are covered from the date of birth. In most cases, the newborn’s name will appear on the PMP’s member list for the month after birth.

For more information, please call the Hoosier Healthwise helpline at 1-800-889-9949, or see the CareSource Provider Manual.