Affordable Indiana Individual Dental Insurance Plans And Rates

Affordable dental insurance coverage in Indiana is offered by several large companies, and rates may be much lower than you realized. Individual and family plans are available from top-rated carriers such as Aetna, Anthem, UnitedHealthcare, Humana, Assurant, and others. We make it easy for you to quickly compare multiple companies and obtain quality benefits at the cheapest prices.

Next-day coverage is often available, and benefits typically include teeth cleanings, restorative dentistry and cleanings, oral surgery, extractions, x-rays, and crowns. Additional benefits can include root canals, periodontics, dentures, bridges, sealant, and endodontics.

Below, we have reviewed and compared the best Indiana dental plan options, and included an online link that enables you to quickly enroll for a policy and get covered. All major carriers that offer benefits are included. NOTE: Metlife dental plans are only available through an employer.

Cheap Dental Benefits In Indiana

Compare Quality Indiana Dental Insurance Plans That Are Also Affordable!

Anthem Blue Cross Blue Shield

Anthem is the largest writer of healthcare coverage in Indiana, with market share increasing each year. You can view their health insurance plans here. Their dental details are shown below.

Anthem Dental Family – Anthem’s least expensive dental plan with a $50 deductible (per person) per year and a maximum yearly benefit payout of $750 (not applicable to dependents 18 or younger). Diagnostic and preventive services have no waiting period with cleanings, exams and x-rays covered at 100%.

Basic services (six-month waiting period for adults) and filling are included in the policy although extra cleanings and brush biopsies are not. Complex and major expenses have a one-year waiting period, although for dependents, it is often waived.

Other included benefits are root canal, scaling, tooth removal, endodontic and periodontic surgery, crowns, dentures, and bridges. Medically-needed orthodontia is covered for children (under age 19), but not adults. Cosmetic expenditures are generally excluded.

Anthem Dental Family Enhanced – Adult deductible is also $50 for all services while children’s (under age 19) deductible is only $25.  The maximum yearly benefit increases to $1,000, and diagnostic and preventive services have no waiting period. However, basic services still feature a 6-month waiting period for adults.

Coverage for fillings is higher than the Family plan (80% vs. 60% and 50%), along with root canal, scaling, tooth removal, endodontic and periodontic surgery benefits. The “Dental Prime” network is utilized and the yearly out-of-pocket limit of $350 still applies to children only (same as previous plan).

Anthem Dental Prime

Three Plans (A, B and C) are offered with different maximum benefits ($500, $1,000 and $1,250). A 12-month waiting period applies to complex and major services for all three plans. Plan A does not cover fillings or a brush biopsy. A $50 deductible applies only to Plans B and C while there is no yearly out-of-pocket limit.

An Optional “Blue Vision” rider is offered that features more than 25,000 network facilities throughout the US. Often retail locations can be used, such as LensCrafters, Target Optical, Sears Optical, and Pearle Vision. Negotiated discounts can reduce prices by as much as 40% at many locations.

An eye exam ($20 copay) is allowed once per year with a pair of glasses (standard lenses) allowed every once per two years ($20 copay). Contact lenses and frames can be replaced every 24 months. Factory scratch coating is a rider that can be added (free) along with polycarbonate lenses for anyone under age 19.

Indiana Dental Plan Rates

UnitedHealthcare Offers Excellent Pediatric Dental Coverage

UnitedHealthcare

UnitedHealthcare is one of the largest and highest rated companies in the industry. Their Life Insurance company actually administrates and offers dental plans. Rated “A” by A.M. Best Company, and with more than 30 million customers, you won’t have trouble finding a network provider.

Primary – The cheapest option, a $50 deductible applies to basic services (6-month waiting period), and a $25 copay (no waiting period) applies to preventive benefits. Major services are not provided on this inexpensive plan.

The annual maximum is $1,000 per person, and the typical out-of-pocket cost for a cleaning is approximately $25 (assuming a network provider). Vision benefits are also available.

Primary Preferred – Similar to previous plan although major services are provided with a 12-month waiting period. Benefits are paid at 50% once the deductible has been reached. Copays and annual maximums are the same as “Primary” plan.

Premier Choice – Basic and major services deductibles are only $50 combined (per person).  For larger families, the maximum number of deductibles is three. No copay or waiting period for approved preventative services.

Basic services (20% copay after deductible) have a 6-month waiting period while major services (50% copay after deductible) have a 12-month waiting period. Orthodontics is not covered and annual maximums gradually increase the first four years.

For example, $1,200 is the maximum the first year the policy is in effect. However, this amount increases by $100 on the anniversary date up to a maximum of $1,500. Network negotiated discounts allow you to pay only $16 for a filling (Amalgam 1 surface) and $385 for a molar root canal.

Premier Elite – Very Similar to prior plan with a major difference. Non-network copays are much lower. For example, a cleaning from a dentist that is not in the UHC network is subject to only a $5 copay (instead of $34). Other minor and major services also receive lower out-of-pocket costs.

Additional information that applies to all UHC plans:

No benefits are paid for expenses that occur before the effective date. This also applies to any waiting periods, or any claim submitted after the policy has been terminated. Also, treatment must be performed in a dental office by licensed personnel.

If injuries were the result of self-infliction, attempted suicide, or war, they will not be covered. Acupuncture and other alternative treatments are excluded. And in most states, if you receive service or treatment from someone that lives with you or is a relative, benefits may be excluded.

Find The Best Dental Plans In Indiana

Humana Helps Make The Trip To The Dentist A Little Better!

Humana

Humana was recently purchased by Aetna, but still offers many attractively-priced plans. We have illustrated the four most popular options below.  An additional policy is available by request. The “Preventative Plus Package For Veterans” requires proof of military service and is a specialized product. The Humana dental network can be found here.

Dental Loyalty Plus – Choice of any dentist, whether inside or outside of network. Deductibles of $150 per person or $450 per family. $1,000 annual maximum benefit increases to $1,500 after three years. Preventative paid at 100% and no waiting period for covered benefits.

Dental Preventive Plus – Similar to previous plan, although the annual maximum benefit does not increase and there is a six-month waiting period for basic services such as fillings and oral surgery. Premium is also lower.

Dental Value – Only in-network benefits and a primary-care dentist must be selected. However, there is no deductible or annual maximum for benefits paid. A small copay applies to visits.

Dental Savings Plus – This policy is classified as a “discount plan,” since it is not considered insurance. A discount applies to in-network dentists. Also included are discounts for vision expenses (up to 40%), hearing services, including an exam, and discounts on drug costs, which are typically 5%-30%. The one-time enrollment fee is $15.


Dental Care Savings That Will Make You :D - Click to Find your Plan

 

Discount Dental Plans

The cheapest option is utilizing one of several available “discount” options. Although they are not considered “insurance,” they do provide savings (often significant) when procedures are performed through network providers. NOTE: The American Dental Association does not endorse any specific plan.

Typically, there are no claims forms and payment is made at the time of service. Listed below are several of the most popular policy options:

Careington Care 500 Series – One of the bigger providers with more than 60,000 network providers. Orthodontics (child and adult) is included along with cosmetic benefits. Surprisingly, vision and Lasik is also included. Routine checkups cost only $16 (70% discount) while adult cleanings require only a $37 copay.

Aetna Vital Savings – Aetna’s discount version includes up to 50% savings on many major procedures including a root canal, crowns, and orthodontia. Prescription drugs are also discounted. Routine six-month checkups cost $24 and  an adult cleaning costs $54.

CVS iSave –  Yes, it is that CVS!National network of more than 100,000 dentists and specialists. Discount of 15%-50% on most major and minor procedures. Routine checkups (adult) cost $21 while cleanings cost $32 (children) or $47 (adults). A simple tooth extraction will cost $56.

10 Wellness programs are added, including TelaDoc, Medical Health Advisor, and Health Wealth Connection. Other extras include fitness discounts, 24-hour nurse hotline, and chiropractic/alternative medicine savings.

CignaPlus Savings – Orthodontia benefits are included along with the large Cigna network of more than 110,000 providers. Referrals are not needed for visits to specialists, and special group pricing is available. Routine checkups and adult cleanings cost $21 and $47 respectively. Depending on the type, a root canal can cost as little as $316.


Ambetter Health Insurance Plans In Indiana

Ambetter individual and family healthcare coverage in Indiana provides affordable options in 28 counties. The parent company, Managed Health Services (MHS) has been providing quality medical coverage to Hoosier residents for 21 years. Marketplace policies can easily be purchased, and rates are often lower thanother major carriers, such as UnitedHealthcare and Anthem Blue Cross and Blue Shield.

About The Parent Company MHS

MHS is a managed care provider that helps operate the Children’s Health Insurance Program (CHIP), Hoosier Healthwise, and Healthy Indiana. In addition to enrollment duties, they coordinate community events and provide public information about existing and future programs. The National Committee For Quality Assurance (NCQA) has awarded its “commendable” designation to MHS for outstanding services.

MHS is actually a wholly-owned subsidiary of Centene Corporation, which is a Fortune 500 company specializing in providing services to government-funded programs for consumers that are without medical coverage. Some of these programs include Medicaid, Aged, Blind, or Disabled (ABD),  and CHIP. Other specialties include managed vision, in-home treatment, special-needs coverage through Medicare, and prescription benefits management.

Find Ambetter Doctors In Indiana

Ambetter Indiana Provider Network

With offices in Indianapolis, Fort Wayne, and Merrillville, Ambetter offers low-cost healthcare throughout much of the state. The 28 participating counties are Adams, Allen,  DeKalb, Elkhart, Huntington, Kosciusko, Marshall, St. Joseph, Wells, Whitley, Boone, Clarke, Daviess, Hamilton, Handcock, Harrison, Hendricks, Henry, Howard, Johnson, Knox, Lake, LaPorte, Madison, Marion, Miami, Montgomery, Porter, Pulaski, Steuben, Tippecanoe, and Vanderburgh.

Network Providers

The network provider list is quite extensive, and includes primary care physicians, specialists, Urgent-Care locations, hospitals, and many other medical and rehabilitation and treatment facilities. For example, if you lived in the Indianapolis area, the following hospitals  would be considered “in-network.” We used a 40-mile radius.

Community Hospital East

Westview

Community Hospital South

Community Hospital North

Heart and Vascular

Community Hospital East

Hendricks Regional

Johnson Memorial

Riverview

Hancock Memorial

Witham Memorial

Community Hospital Of Anderson

Putnam County

What About Doctors?

The availability of primary care physicians (PCP) allows you to choose from many doctors within your area. Specialists, behavioral health, dental and vision options are also plentiful. We listed below the number of network PCPs in several large and small cities. After each city, shown is the number of providers within a 20-mile radius. Typically, the number of available providers increases each year. NOTE: A 24/7 nurse advice line is also available. Registered and licensed nurses can provide professional assistance to current policyholders.

Bloomington – 5

Brownsburg – 172

Carmel – 198

Evansville – 12

Fort Wayne – 95

Hammond – 106

Indianapolis – 212

Lafayette – 5

La Porte – 25

Lebanon – 73

Muncie – 54

Richmond – 4

South Bend – 144

Valparaiso – 194

Vincennes –  26

NOTE: You can also search for your Ambetter provider here.

 

“Start Smart” For Pregnant Women

Pregnant women benefit from a special program designed to provide support, education, and guidance. A “Notification Of Pregnancy” (NOP) form is required to be completed before services are provided. Maintaining healthy lifestyle habits, resting regularly,  and avoiding drugs, alcohol, and tobacco products are often discussed. Counseling and therapy can also be provided.

Wellness Benefits That Pay You

Current policyholders are rewarded by participating in preventative activities and maintaining good health. A prepaid credit card (My Health Pays Visa Prepaid Card) is utilized to accumulate your earned dollars. The reward points can be used to pay many common out-of-pocket costs, such as physician copays, deductibles, coinsurance and your premium each month. NOTE: Prescription copays are not part of the program.

Common items that are available for accumulating dollars include:

$50 – Completing initial “Welcome” survey.

$25 – Annual flu shot.

$20 – Monthly reimbursement for visiting exercise facility or gym at least eight times.

$50 – Annual wellness exam.

Additionally, discounts and price reductions on gym memberships and health clubs are offered. Zumba, Schwinn, and Stairmaster products also may be available at lower pricing.

2017 Ambetter Indiana Marketplace Plans (Vision And Adult Dental Benefits Can Be Added To Most Plans)

Policies are divided into three tiers. Essential (Bronze) covers basic needs, with emphasis on major medical expenses. Premiums are the lowest but out-of-pocket costs are the highest. Balanced (Silver) offers lower rates and less risk for large claims. If you qualify for a subsidy, this tier is often the best option because of “cost-sharing” that reduces the copay and deductible. Secure (Gold)  policies are the most expensive, but also feature the lowest copays, coinsurance, and deductibles.

 

Bronze Tier

 

Essential Care 1 – Least expensive plan in portfolio. $6,800 deductible with 0% coinsurance. Thus, maximum out-of-pocket cost per individual is $6,800. Generic drugs ($20 copay) are not subject to the deductible. An annual eye exam and one pair of glasses included (no copay) for children.

 

Silver Tier

 

Balanced Care 4 – $30 and $60 office visit copays, with Urgent Care copay of $100. Deductible is $7,050 with maximum out-of-pocket expenses of $7,050 and 0% coinsurance. Generic and preferred brand copays are $15 and $50. Non-preferred and specialty drugs must meet deductible.

 

Gold Tier

 

Secure Care 1 – $1,000 deductible with $6,350 maximum out-of-pocket expenses. Three free pcp office visits are allowed although specialist visits must meet the deductible first. A $500 deductible also applies to all prescriptions except generic drugs ($10 copay). There is also a 20% coinsurance once the deductible has been met.

 

ffordable Ambetter Hoosier Plans

Save Money On Federally-Subsidized Plans

NOTE: On selected plans, three free PCP visits can be added.  When this option is selected, a deductible does not apply to unexpected doctor visits for flu and other symptomatic  expenses. Preventive benefits are covered at 100% on all Metal plans without a copay, coinsurance, deductible or waiting period.

Federally Subsidized Plans

If your household family income is less than 400% of the Federal Poverty Level (FPL), and you are not offered “affordable” medical coverage from an employer, you are probably eligible for financial aid to help pay your premium. These subsidies become larger as the size of your family grows. Thus a six-person household could qualify for as much as $400-$600 per month more in aid than a two-person household.

The actual amount of your instant tax credit is based on the cost of a “Silver-tier” policy in your designated area. Of course, you can also purchase a Gold, Platinum, or Bronze plan. A “catastrophic” plan requires the applicant to be under 30 years old. NOTE: Although the subsidy instantly reduces your premium, you may also elect to defer the credit and receive a  refund the following year when you file your tax return. However, if you underestimate your income, you will have to pay part of the subsidy back.

How Rates Compare With Other Companies

Our “sample” household is a a 43 year-old single person living in Hendricks County with an annual estimated income of $30,000. We have illustrated below several rates (monthly) from the most competitively-priced plans:

$145 – Ambetter Essential Care 1

$149 – Ambetter Essential Care 2

$158 – Anthem Pathway X 0

$182 – Anthem Pathway X 5750

$191 – MDwise Marketplace

$194 – CareSource Just4Me Healthcare With Heart

$206 – Ambetter Balanced Care 2

$230 – Anthem Pathway X 10

 

Senior Plans (Medicare Supplement and Medicare Advantage)

Ambetter does not offer these types of contracts at this time. Persons that have reached age 65 and are Medicare-eligible, can compare the most popular plan options throughout our website. The Open Enrollment period is different than the Under-65 period.

 

Latest News

January 2015 – Managed Health Systems (MHS)  will be working with Medicaid-eligible residents who meet the requirements of Hoosier Care Connect, which begins in April of 2015. More than 80,000 older, disabled or blind persons will be participants in the program. More than 10,000 doctors and specialists will help with the treatment. MHS has almost 20 years of experience  working with Medicaid patients in the state.

August 2015 – Projected 2016 rates are expected to reduce as much s 7%, according to initial filings. Celtic (Actually Celticare) will now be involved in the underwriting and distribution of products. However, Celtic no longer offers policies under their own brand name.

October 2015 – Ambetter’s individual plan portfolio is more streamlined for 2016. Also, prices, which were already competitive, have become more attractive compared to Anthem and other carriers. Increased preventative care benefits will also reduce expenses for many customers.

November 2015 – The most recent Formulary Drug Guide has been released. Generic drugs, which have the same active ingredients as brand-name drugs, should always be considered first. There are five tiers of prescriptions, ranging from 0 (typically free preventative drugs) to 4 (expensive specialty drugs). The complete listing can be found here.


Indiana 2016 Obamacare Health Insurance Exchange Guide

Obamacare health insurance plans in Indiana for 2016 have been filed with the Department of Insurance. Once again, individual and family medical coverage is available through several companies with instant federal subsidies provided to households that meet the  Federal Poverty Level (FPL) guidelines. Hoosier residents can not be denied for medically-related conditions when enrolling for Exchange policies.

Open Enrollment

Open Enrollment began on November 1st and ends on January 31st (2016). During this three-month period, no special exemption is needed to obtain guaranteed-approved plans that are eligible for federal subsidies and coverage for pre-existing conditions. Applying for coverage now takes approximately 10-25 minutes, instead of 60-90 minutes (last year).  The new streamlined approach saves you time, frustration, and money!

Our website allows you to quickly obtain a policy at the guaranteed lowest available rates. Whether it’s Anthem, UnitedHealthcare, Aetna, MDwise, Ambetter, or any other company, lower prices (by law) can not be offered anywhere else. Our 35 years of expert advice  and plan comparisons will help you every step of the way. NOTE: Humana and Assurant no longer offer Exchange contracts.

Navigator precertification, training and continuing education  also helps Hoosier residents understand many of the changes that are effective for 2016. Lists of training and PE course providers are available to the public. Of course, we are required to submit agent and broker FFM registration to verify proper licensing and compliance. Continuing education is also required every other year.

Latest Enrollment News: If you forgot to sign up for a plan, you may still be able to enroll by taking advantage of an SEP (Special Enrollment Period) exemption. Otherwise, there are also numerous policies that can be purchased that will offer quality benefits at a price that fits within your budget. However, plans non-compliant with Obamacare may not offer federal subsidies or pay for certain pre-existing conditions.

Rate Changes From 2015 To 2016

Projected prices for private plans will greatly vary, depending on the carrier. While some companies have lowered rates by as much as 10%, other carriers have increased premiums as much as 50% on selected plans in specific areas. Large rate hikes are mainly due to increased claims by existing policyholders and higher overall medical expenses charged by physicians, hospitals, inpatient and outpatient facilities, and other related costs.

NOTE: For many areas, Anthem and UnitedHealthcare are offering the most competitive prices. MDwise, in selected counties, also offers affordable options. Three of the least expensive policies offered are the Anthem Bronze Pathway X 20, Anthem Bronze Pathway X 0, and UnitedHealthcare Bronze Choice HSA 4900.  Ambetter also offers very competitive options in Indianapolis and other areas.

Although several other states manage and operate their own Exchanges, Indiana will continue to allow the federal government operate its Marketplace, including administration and software updating and management. Why? It’s all about money. Although having the flexibility to expand the Open Enrollment period would be beneficial, the $40-$50 million annual cost of maintenance would have to be accounted for. At this point, allowing a federally-run Exchange is the most cost-efficient.

Off-Marketplace Options

“Off-Exchange” policies are also available. These plans  do not involve the federal healthcare website. Since the Obamacare subsidy does not apply, they should only be considered for high-income earners that are not eligible for financial aid. Most carriers that offer policies “on” the Marketplace, offer “off” plans as well.

Prices and benefits are similar to “on-Exchange” policies (sometimes the cost is less), and often the number of network providers is expanded with additional specialist and facility options to choose from. Also, the application process is more streamlined and policy approvals occur very quickly, instead of waiting for a few weeks. The federal website is not utilized, and thus, many hours (days) of administrative work are not needed.

Non-Compliant Options

Non-Compliant Healthcare Covrage

Short-Term Plans Provide Cheap Temporary Student Coverage

Also available are “non-compliant” policies which are also purchased away from the Marketplace. The most common (and popular) type of coverage is a short-term contract designed to provide inexpensive major medical benefits. Rates are cheap and the application process takes less than 30 minutes. UnitedHealthcare is one of several carriers that offers temporary contracts.

We compare short-term health plans in Indiana by reviewing several of the carriers that specialize in this product. Contract provisions are very similar, although some of the available riders vary (such as life and disability benefits, critical illness, and extra accidental coverage). You can expect to pay out-of-pocket for many items that normally are covered in full or with a copay. Examples include preventative benefits (annual physical, OBGYN exam, mammogram) primary-care office visits, non-generic prescriptions and trips to Urgent-Care.

But they do not bypass the special penalty for not having complaint coverage, so you may have to pay an additional tax of up to 2.5% of your adjusted gross income (up from 1% in 2014). If you only utilize  this type of policy for a portion of the year, your penalty will be pro-rated. Generally, the first three months of the year you are not complying with the law result in no fine or penalty.

Other “non-compliant” plans include critical illness and “specific disease” plans. This form of policy is designed to supplement existing Exchange coverage by paying a portion (often a large portion) of your out-of-pocket costs if you are treated for a specific disease or illness. But when they act as “stand-alone” coverage, they don’t meet ACA  guidelines. Typically, we do not endorse these contracts since major medical expenses could be left uncovered.

Affordable Care Act Legislation And Its Impact In 2016

Another factor is that 2014 was the first year that health insurance companies were not able to “underwrite” plans based on existing and pre-existing conditions. Only smoking status, age and zip code can be used when determining the cost of coverage. Of course, the federal tax credit substantially reduces premiums for many Hoosier residents. About 9 out of every 10 applicants in 2014 and 2015 qualified for a subsidy.

For 2016,  the vast majority of applicants will receive financial assistance. Medicaid is now offered to lower-income single persons and families. A plan to expand Medicaid is currently being considered by the Center for Medicare and Medicaid Services. “Healthy Indiana Plan 2” may become a reality within the next 3-6 months. The federal waiver request, if approved will provide low-cost medical benefits to more than 300,000 additional persons in the state.

Missed The Deadline?

For consumers that miss Open Enrollment, there are many available options, including temporary policies (designed to be kept less than 12 months) and “qualified life events” that allow a special exception to be made. We discuss them here and they are offered all year. For example, if you lose coverage because of a divorce, loss of job, cancellation or non-renewal of plan, or move to a different area, you are granted approximately 60 days to enroll in a new plan.

If you don’t qualify for any of the many approved exceptions, as mentioned above, an extremely inexpensive option is to purchase a short-term policy until the next OE period. Premiums are cheap, policies can be approved within a few days (or less) and the two-page application takes less than 30 minutes to complete.  Major medical expenses are well-covered. UnitedHealthcare is one of several carriers offering cheap rates.

But, short-term plans lack many of the new required benefits, so a special 2.5% household income surcharge applies. Any existing conditions are not guaranteed to be covered. Acceptance  by the insurers is also subject to an underwriting review, which differs from Exchange plans. But often, if you have a gap in benefits and don’t qualify for a special enrollment exception, it’s your best recourse. However, since policies can only be kept for up to 12 months, they are not a permanent solution.

 

Anthem Plans

Healthcare Companies in Indiana

There are new healthcare plans and prices for Indiana in 2015

Anthem Blue Cross Blue Shield issues more policies than any other company in the state. They are requesting an increase between 9% and 10% on their individual business. The higher premiums are justified by the older ages of many applicants last year along with associated higher medical cost (as previously mentioned).

For 2016, Anthem offers a new portfolio of plans that utilize the cost-saving Pathway X network. Several of the most economical plans are listed below:

Bronze Pathway X 4950 50 – $5,000 deductible and 50% coinsurance. Cheapest non-catastrophic plan.

Bronze Pathway X 5850 35 – Similar to 4950 50 plan but with $5,850 deductible and  35% coinsurance.

 Bronze Pathway X 20 For HSA – Nice HSA plan with $4,500 deductible and 20% coinsurance.

Silver Pathway X 4250 30 – Impressive $25 copay for primary-care physician visits and $50 copay for specialists. Coupled with a $4,250 deductible, this plan should always be considered if you qualify for a federal subsidy.

 

MDwise

MDwise filed for a rate increase on most plans. Although not one of the “big players” in the state, it was hoped that they could gradually increase market share. With slight increases expected in 2016, competitive pricing is expected. In selected areas, their prices will be lower than most other companies. The most competitive plans offered by MDwise are listed below:

Marketplace Bronze Basic – Low $20 pcp office visit copay, which is unusual for Bronze-tier options. Deductible is $6,200.

Marketplace Bronze Plus – Similar to previous plan, but with $10 pcp copay and $4,800 deductible.

Marketplace Silver Basic – No charge for pcp office visits and $5,000 deductible. Plan is eligible for “cost-sharing.”

Marketplace Silver Plus – Similar to prior plan, but with lower deductible ($2,500) and higher generic drug copay ($20 vs. $15).

 

Physician's Health Plan Insurance Quotes

PHP Marketplace Plans Are Available In Northern Indiana Counties

 

Physician’s Health Plan (PCP)

Last year, the largest proposed increase was submitted by Physician’s Health Plan with a 46% request. Their network  covers only Northern Indiana and some of the Central counties, so most residents are not impacted. Their most popular policy options are shown below:

Marquee HSA Bronze 6000 – HSA-eligible plan with $6,000 deductible.

Marquee Bronze 5000 (HMO and POS) – $5,000 deductible with $50 copay (and 50% coinsurance) on pcp office visits.

Marquee HSA Bronze 3750 – HSA-eligible plan with $3,750 deductible and 40% coinsurance.

Marquee HSA Silver 3500 – HSA-eligible plan with $3,500 deductible and $4,500 maximum out-of-pocket expenses.

Marquee Silver 2000 – $2,000 deductible with $30 copay on pcp office visits.

Marquee Gold 1250 – Low $1,250 deductible with $35 pcp office visit copay. Generic drug copay is $15.

 

Ambetter

Ambetter offers many low-cost plans in the central and northwestern portion of the state, along with four counties located in the southern region. In addition to competitively-prices policies, also available is optional dental and vision benefits, a 24/7 nurse line, member wellness health incentive program, and very comprehensive prescription coverage on upper-tier plans.

One of the cheapest options for single and family households is the Bronze Essential Care 1,2, and 3 plans. Each policy offers optional dental and vision benefits that are extremely inexpensive. For example, a 50 year-old in Hendricks County that makes $24,000 per year, will pay only $94 per month for the “1” policy.

Adding dental and vision coverage will only increase the rate by $31 to $125. Although the deductible is high, each of the 10 “essential health benefits” are included. Shown below are popular low-cost plan options:

Essential Care 1 – $,6800 deductible with $20 generic drug copay.

Essential Care 5 – Three free pcp office visits and a $6,800 deductible.

Balanced Care 2 – Cheapest Silver-tier plan with $25 and $50 office visit copays and a $4,500 deductible.

Balanced Care 1 – Office visit copays of $20 and $30 with lower $3,500 deductible.

Balanced Care 10 – Very low $10 and $20 office visit copays along with $5 generic drug copay. Deductible is $4,000.

Secure Care 1 – Gold-tier plan with $1,000 deductible but no copays for office visits and maximum out-of-pocket expenses of $6,350.

 

Additional Companies Offering Coverage

 

There are also four new carriers that  offer 2016 on-Exchange plans. Proposed premiums were approved by the Department of Insurance. The four companies are:

All Savers (UnitedHealthcare).

Care Source, which is a managed-care company.

IU Health Plans began offering plans in 2016. They partner with the Indiana University School of Medicine, and offer very competitively-priced plans in their service area. In addition to single and family Marketplace plans, IU Health also offers Medicare Advantage plans in Indiana. Listed below are several of their most popular and affordable policies for applicants under age 65:

Bronze Simple HSA – $6,500 deductible and HSA-eligible.

Bronze Value – $6,000 deductible with $40 copay on pcp office visits and $16 generic drug copay.

Silver HSA – $3,000 deductible and HSA-eligible. $4,500 maximum out-of-pocket costs.

Silver Copay – $30 and $60 office visit copays with $2,500 deductible.

Gold Value – Low $750 deductible with $20 and $50 office visit copays. $9 copay for generic drugs.

 

Southeastern Indiana Health Organization, who, as expected, will offer policies predominantly in one portion of the state.

We will continue to keep you informed of any changes for 2016 and how to easily enroll in the most affordable health insurance plans in Indiana.

UPDATES:

August 2014 – A lawsuit seeking to end federal subsidies for the purchase of health insurance will proceed to trail. Initiated by Governor Pence, the basis of the lawsuit is that Indiana did not set up a state Marketplace (instead opted for federal), and therefore should not receive the Obamacare tax credits.

Pence has stated that he feels it is unconstitutional to force consumers to buy coverage and subsequently face tax penalties for non-compliance. More than 100,000 Hoosiers received subsidies in 2014 when purchasing Exchange plans.

It is expected that this lawsuit will not ever reach the point where a jury is picked. Similar lawsuits have already been filed, and are expected to be settled by the US Circuit Court of Appeals.

October 2014 – NorthShore Health Centers (in Portage) has been granted $1.5 million from HHS to help treat patients in the Northwestern portion of the state, including Lake and Porter Counties. Treatment is offered to persons in the area that either have not enough or no coverage.

November 2014 – UnitedHealthcare is offering several very attractive 2015 policy options. The Silver Choice 2000 plan features a fairly low $2.000 deductible with copays on most office visits and prescriptions ($30-primary care physician). The Gold Choice 1250 offers a $1,250 deductible with very low copays on primary care physician and specialist visits ($10 and $30 respectively). It’s actually less costly than many Bronze and Silver policies.

March 2015 – An upcoming Supreme Court Ruling will have a huge impact on about 200,000 Hoosier residents. King Vs. Burwell impacts federal subsidy availability in states that have not set up their own Marketplace.  Although the legislation originally intended that all persons would be eligible for financial assistance, regardless of the status of their State Exchange, the exact verbiage did not match the intent.

A decision is expected this summer although regardless of the outcome, 2015 subsidies may not be affected since a quick temporary legislative fix can probably be enacted.

November 2015 – Federal subsidies were upheld in the King Vs. Burwell ruling. We don’t anticipate any major legal challenges until possibly 2017. However, minor court rulings can be expected on the legality of requiring contraceptive coverage in certain employer-based plans.