Indiana will ask Medicaid members to prove their work hours four times a year, and Illinois will ask twice. Beginning January 1, 2027, the Healthy Indiana Plan (HIP) checks hours every three months, while Illinois verifies every six. Both states are applying the work rule in the 2025 federal law that President Donald Trump signed, H.R. 1, known as the One Big Beautiful Bill Act.
Indiana HIP, every three months: Hours are checked quarterly while renewals run every six months, and The SNAP & Medicaid Renewal Organizer includes a renewal and reporting calendar.
Work out hour-check and renewal dates on one calendar →
A quarterly hours check inside a six-month HIP renewal
Indiana’s Family and Social Services Administration (FSSA) describes the rule for members on its HIP work requirements page, updated September 23. Starting January 1, 2027, Indiana Medicaid applies work requirements to new applicants and to existing members. The page says a member needs at least 80 hours every month, and puts the schedule plainly: “You renew HIP every six months, and the state checks your hours every three months.”
For someone applying, the state looks backward. The page describes a three-month window before the application month. A new applicant therefore needs a record of work or qualifying activity reaching back three months before the month of the application, not only from the day of signing up.
Illinois verifies every six months and looks back one month
The Illinois Department of Healthcare and Family Services (HFS) sets a slower rhythm in its FAQ on federal changes to Medicaid. Beginning January 1, 2027, adults in the ACA Adult expansion group face the work requirement, and the state will verify eligibility, including work requirements, every six months. For an applicant, the FAQ says the requirement is met in the month before applying.
The arithmetic behind “twice as often” is simple. Indiana’s three-month cycle produces four hour checks in a year, and Illinois’s six-month cycle produces two. A check every three months happens twice as often as a check every six.
Illinois’s own changes page adds the timing for people already covered. New applicants are subject to the rule if they apply after 5:00 p.m. on December 31, 2026, and current ACA Adults face it at the first redetermination on or after January 1, 2027. The page also says redetermination cycles for these adults move from 12 months to six.
The 2025 law sets the floor, and states pick the calendar
The federal rule comes from the 2025 law, and the Centers for Medicare & Medicaid Services (CMS) has laid out the details in an interim final rule fact sheet. It covers non-pregnant adults ages 19 to 64 in the Medicaid adult group, in 43 states and the District of Columbia. A person meets it with 80 hours a month of qualifying activity or with earnings of at least 80 times the federal hourly minimum wage, which CMS puts at $580 a month in 2026. States must implement by January 1, 2027.
Federal law fixes the target, and the states decide how often to check. A KFF survey published in April found that 34 states plan to verify compliance every six months, and only Indiana and New Hampshire plan to do it quarterly. KFF also reported that Indiana and Idaho will look back three months for applicants, while 36 states will look back one month. Indiana’s quarterly cycle is therefore the tightest in the survey on both counts.
What Indiana says happens when hours fall short
Indiana’s page states the consequence in blunt terms: coverage stops, and the member must reapply. It adds that a member also can’t get Marketplace financial help during that time, a point the state makes and that CMS’s fact sheet does not address. CMS says that people who are disenrolled may reapply at any time, and describes noncompliance as leading to a denied application or a disenrollment.
The Marketplace detail matters for a household budget. Losing HIP does not simply move a member to a subsidized plan, according to Indiana’s own page, so a missed hours check can leave an adult without both Medicaid and premium help.
A three-month check and a six-month renewal run on separate clocks
The difficulty in Indiana is that two schedules overlap. The renewal comes every six months, the hours check every three, and the application look-back reaches three months behind the month of the request. A member has to know which clock a given notice belongs to. The state and CMS pages read for this article do not list the specific documents that prove 80 hours in a month, so the paperwork a caseworker will accept is a question for FSSA.
Exemptions are a second unknown. The Indiana page and the CMS fact sheet, as read for this article, do not set out a full exemption list, so who is excused from the 80-hour test is another question to put to FSSA. The Illinois pages at least define the ACA Adult group as people aged 19 to 64 with no dependent children under 18 who are not enrolled in Medicare, which shows that eligibility categories, not only hours, decide who faces the rule.
Reporting hours directly to Indiana’s Family and Social Services Administration is free and needs no paid help, and the FSSA page remains the place to confirm the current instructions.
Keeping a HIP renewal and hours calendar straight
Indiana’s rule stacks a three-month hours check on a six-month renewal and a three-month look-back for new applicants. The calendar is the difficulty, because each date belongs to a different clock.
The SNAP & Medicaid Renewal Organizer covers the new Medicaid work requirement and who is exempt, and includes a renewal and reporting calendar and a renewal document checklist for tracking each date.
Read the work-requirement and exemption section of The SNAP & Medicaid Renewal Organizer →
This article was prepared with AI assistance and checked against the cited Indiana, Illinois, CMS and KFF sources.
