Indiana Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
September 14, 2020

The folks in Indiana have some options in terms of health care. Buying health insurance can unfortunately be a daunting task, so we’ve gathered up all the information you need to make some informed decisions. If you’re eligible for Medicare, skip down to the relevant sections. If you’re in need of health insurance, it’s important to note that you can only buy coverage during the open enrollment period (OEP) in your state, or else you’ll need to wait another year. Only a qualifying event will allow you to enroll outside the OEP.

When Is Open Enrollment in Indiana?

November 1, 2020 - December 15, 2020. Coverage begins January 2021.

How to Get Health Insurance in Indiana

It’s a good idea to have a projection of healthcare costs before you buy health insurance. You can do this with a glance back at the previous year. How often did you see providers and how much did it cost you? What level tier plan do you have? Would a higher premium reduce your overall costs? You’ll need this information to decide which type of coverage is right for you for the following year.

The best way to get a good plan at a low cost is to compare health insurance companies and health insurance quotes. After you fill out a brief question, SmartFinancial will match you with an agent near you who sells the best type of plan for your needs.

What Types of Health Insurance Are Available in Indiana?

HMOs, EPOs, PPOs and POS plans are the most common plans available in Indiana. But you can also buy catastrophic and short-term plans. Most people buy from the tier options, bronze, silver, gold and platinum plans. Bronze plans cover 60% of all costs, silver 70%, gold 80% and platinum 90%.

Does Health Insurance Cover Pre-existing Conditions?

It is illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Indiana

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify to buy health insurance outside the open enrollment period:

  • If you lost, changed or quit a job, you can purchase a new plan. You are also eligible if you started your own business.
  • If you turned 26, you can no longer remain on your parents’ health insurance plan. But you can enroll in an individual health plan.
  • If you moved to another state or out of a plan’s coverage area, you can buy a new health plan.
  • If you extended your healthcare with Cobra and it expires, you can buy a new health plan.
  • If you shared health insurance coverage with your spouse but you divorce, you can buy a new health plan.
  • If you recently married, you can add yourself to your spouse’s policy (or vice versa) or you may buy a new one together.
  • If you have a new baby or adopt a child, you can buy a new plan for that child.
  • If you were covered under your spouse or partner’s health plan but that person passes away, you can buy a new health insurance plan.
  • If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy a new plan.

Is Health Insurance Required in Indiana?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Indiana?

The average cost of health insurance in Indiana for a 40 year old is about $420 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Indiana

Compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs as mentioned earlier.

Medicare in Indiana

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Indiana?

19% of the people living in Indiana are covered by Medicare for health insurance. Do you qualify for Medicare? See more below.

How Much Is Medicare in Indiana?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Indiana

If you receive social security payments, you will probably automatically enroll in Medicare, but you may have to sign up if you do not. You can also enroll in Medicare by working with an insurance agent to choose the right plan. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Indiana?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Indiana State Health System Ranking

  • Indiana: Overall State Ranking: 38 of 51
  • Indiana: Overall Performance: Worse than Average
  • Indiana: Access & Affordability: 24
  • Indiana: Prevention & Treatment: 40
  • Indiana: Avoidable Hospital Use & Cost: 41
  • Indiana: Healthy Lives: 43
  • Indiana: Health Care Disparities: 31
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Indiana Health Insurance Coverage

The people of Indiana have different kinds of health insurance while some Indiana residents are not insured at all. See the breakdown below:

  • Private coverage: 55%
  • Medicaid: 18%
  • Medicare: 19%
  • Uninsured: 10%

Indiana Health Insurance Companies

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