Indiana Health Insurance Rates - Affordable Indiana Health Insurance Quotes

Medicaid Expansion In Indiana – Accept Or Reject?

Expanding Medicaid in Indiana will expand healthcare coverage to more than 350,000 Hoosier low-income residents. Currently, their income excludes them from qualifying for Medicaid, but often it’s not enough to purchase their own individual policy. Statewide, there are more than 800,000 persons without benefits, although many will obtain coverage in2014 when the State Insurance Exchange opens.

Governor Mike Pence is holding off on the Medicaid expansion legislation, and is hoping that simply expanding the HIP (Healthy Indiana Plan) concept and retaining some cost-sharing control will be the best option. This concept has some support from both Democrats and Republicans and would cost very little to those that qualify. Residents that are not eligible can obtain coverage through the Marketplace.

But the federal government (so far) has nixed that idea as a viable alternative. Since time is running out, many citizens and lawmakers on both side of the political aisle are concerned an opportunity may be lost. They feel the government offer will put less strain on hospitals since less uninsured patients will be visiting the emergency room.

What Is The Government Offer?

Will Indiana Medicare Expansion Happen?

Expansion of Medicaid has been made available because of the passage of “The Affordable Care Act.” Indiana would receive approximately $1.7 billion in aid and benefits would be extended to households with incomes of 100%-400% of the federal poverty level. About half of US residents that are currently not insured, would instantly become covered.

One Midwestern University study showed that accepting the government offer would create a small boom in the state economy (to the tune of over $3 billion). The study also predicted that more than 25,000 new employment opportunities would be created over the next seven years. While we don’t dispute the numbers, they are are speculative and impossible to verify right now.

Some support is coming from area hospitals such as the CEO of Columbus Regional Hospital who feels the government offer should be accepted. But a major concern of many legislators across the country is that the current administration will not keep its part of the agreement and will halt, suspend or reduce funding. And recently Florida reversed course and decided to accept the offer from the Obama administration.

However, it is perhaps true that if so many persons in Indiana remain uninsured because of the affordability of their healthcare costs, guess who ultimately pays for their treatment (preventive, ER visits, Urgent Care etc…)? Those that are actually insured and paying premiums assume the extra cost by paying higher prices.

What Is The Latest?

The House Public Health Committee approved legislation by an 8-5 vote Senate Bill 551 which provides a doorway for Governor Pence to negotiate with Washington. This new approval gives Pence a bit more leeway in his negotiations. For example, if the federal government reduces its expected federal aid, all bets are off with Washington.

It appears very clear that we need to find a way to provide benefits for the 350,000 residents that need our help. Either through Medicare expansion or a tweaking of the HIP that will result in federal government approval. But time is running out.

Do I Have To Buy Medical Coverage

Do you have to buy medical coverage? Well, not yet. Right now, it is not against the law to terminate an existing health insurance policy or be without benefits. Of course, you are taking a very big financial risk by letting an existing policy lapse or simply choosing not to purchase an Indiana policy. But it is your right and perhaps it makes sense. How? Quite simply, if you can’t afford to pay the premium, and you had to sacrifice food or shelter, it would be difficult to dispute that logic.

But what happens if you are hospitalized and have no coverage? Yes, you would be treated and any medically necessary surgeries or procedures would be performed. Presumably, the care you would receive would be equal to most other patients that were covered under an individual or group policy. However, additional treatment by out-of-town specialists for a rare illness (if needed) may be a different situation.

For example, if you have a rare form of cancer, and the best treatment is in Houston, you may have to accept treatment in Indiana. Of course, that’s not so bad since there are many fine facilities here. My point is that although without coverage, you will still be helped. Naturally, if you had benefits with a major carrier, you could possibly be treated in Houston, or many other facilities in the US.

However, just because you are uninsured, does not mean you won’t have to pay a fair share of the outstanding bill. Once you are reasonably recovered at home, it is customary (and rightfully so) for the hospital to request either immediate payment or to begin negotiations for payment of the bill. Often, it is in the form of small monthly payments that can go on for quite a while, depending on your financial situation. But, as previously mentioned, you still won’t be forced to buy health insurance.

Buying Health Insurance Is The Law In 2014

But this changes in 2014. If you don’t have in-force coverage, you will have to pay a tax. The details are here although we will try to explain the tax (or you can call it a penalty). Quite simply, you pay the greater of a pre-determined amount ($95 in 2014 and increasing to $695 in 2016) or 1% of your 2014 income, gradually increasing to 2.5% in 2016. If you are under the age of 18 and are a dependent, you are only responsible for 50% of the tax. However, your tax will not be higher than the cost of the actual coverage you should have purchased.

What about the new policies available in 2014? You’ll choose between bronze, silver, gold and platinum plans. As you may have guessed, the platinum version will cost the most and have fewer out of pocket expenses. The bronze option may become one of the most popular choices, since it may be the only affordable contract. You’ll pay more if/when you have a big medical bill, but the premium should be budget-friendly.

Remember…if you don’t have a lot of income, you’ll be rewarded with some tax help. Additional Exchange information is on this page. Instead of receiving a tax credit that you have to file your tax return to receive, the subsidy will be instant, and immediately save you money. No waiting for rebates or a tax refund to come in the mail.

It appears that it will not be uncommon in 2016 (and beyond) to see taxes of $2,000 or more, imposed on many families for not purchasing health insurance in Indiana. This is one reason we hope that “Outside Exchange” plans will be available. These types of contracts may have wider networks and perhaps lower costs than the government-mandated options. Keep checking our website for details and updates. Although you’ll probably still have to buy coverage, we will search for any affordable options that continue to be created.

What’s The Best Copay For Your Insurance?

The copay and deductible on your health insurance policy has a tremendous impact on the rate that you pay. A higher deductible will reduce your premium, and the savings could be substantial. And of course, lowering the copay or deductible will raise your premium, and perhaps cause you to pay for coverage that you rarely or never use. So when you purchase medical insurance in Indiana, what do you do? We’ll help you decide the best options.

Most healthcare providers in Indiana offer a wide range of deductible options. Deductibles as low as $500 (sometimes $250) can be found along with options as high as $25,000! And yes, with a deductible like that, you’ll be paying for everything out of your own pocket. But your premium will be extremely cheap! HSAs often have similar options. (Additional HSA information can be found here.) Typically, a deductible between $2,500 and $5,000 will make the most economical sense.

When determining which option is right for you, it’s important to consider your health and how many claims, and what types of claims you typically have in a year. While you don’t want to pay for benefits you will never use, you certainly don’t want to leave yourself in a position where a large claim will cause a financial dilemma. However, if you were to choose the “high deductible” path and subsequently incur a major claim and thus, face a large out of pocket bill, there may be help.

Large Healthcare Bills Can Be Paid

What About The Large Bill?

Usually, it’s a large hospital bill that is the biggest challenge. It may just be a few thousand dollars or perhaps as much as $10,000 depending on your policy limits. But many hospitals and similar medical facilities will negotiate your obligation and perhaps offer attractive and flexible terms regarding payment of the bill. Although it’s not their financial obligation to negotiate with consumers, they often will since it is often the only way to collect a debt.

For example, assuming that after all the claim forms had been processed and the treatment had been completed, let’s suppose your outstanding bill was $6,000. And of course, this was owed to the hospital that treated you. Although it’s not guaranteed, you may be able to negotiate a payment plan. Perhaps $150 per month for four years or even $125 per month for four years. Each hospital will have its own guidelines.

Important: We don’t encourage any patient to ignore or simply not pay a bill. We are simply pointing out that in some instances, you may be able to alter the terms. Each hospital will have different billing procedures. Some of the larger hospitals in the state are Indiana University Health Methodist, St. Vincent, Franciscan St. Francis and Ball Memorial.

Can You Change?

Yes, you can change your deductible…most of the time. Now what does that mean? Policies typically renew every 6 or 12 months. It is possible that you may only be allowed to alter your coverages at the time of your renewal or possibly within 30-60 days of that renewal. Each Indiana carrier is different so it would depend on the company you carry your benefits with. So naturally, if your plan started in January and you wanted to raise or lower your deductible, you may have to wait until July or the following January.

Another scenario involves your medical history. For example, if there has been no significant change in your health since you purchased the policy, then there is no reason why you could not increase or decrease your limits at the designated times your insurer provides. Of course, you may have to answer some medical questions to verify there are no pending surgeries or procedures.

However, if you became uninsurable, it is possible that many companies would not let you alter certain parts of the policy, including the deductible. In 2014, when the Indiana Marketplace Exchange becomes operative, it will not make a difference since existing medical conditions will not affect policy coverage or premiums. However, after that date, if you are being treated for a chronic sickness or illness, it will become extremely important to discuss which copays and deductibles minimize your out of pocket costs.