The 2017 Health Insurance Exchanges in Indiana provides extremely affordable medical coverage in all areas of the state. Whether you're a young adult, or nearing Medicare-eligibility, each Metal tier offers several very attractive individual and family policies. If you apply during the Open Enrollment period, your pre-existing conditions are covered and your rates may dramatically drop if you qualify for a federal subsidy.
We make it easy for you to find the cheapest Marketplace rates in the Hoosier state for both single and multi-person households, and also subsequently enroll for coverage. Our direct application links reduce the enrollment process by 50% and expedites the approval of the policy. It only takes about 20 minutes to purchase a policy with or without a federal subsidy.
Note: Indiana Medigap coverage is available to Seniors that are Medicare-eligible. The Open Enrollment Period is from October 15th through December 7th for 2017 effective dates. However, a 7-month window is also provide that surrounds the month you reach age 65. Advantage, Supplement, and Part D prescription drug plans are offered from many companies. MedSup plans are standardized while Advantage contracts often include prescription benefits.
Below, we have examined and compared all available plans in the state so you can view the least expensive options in your area. Of course, depending on your overall health, often a more expensive upgraded contract may be the most cost-effective option in covering your medical expenses. However, if you qualify for a federal subsidy (we'll calculate the amount for you), a cost-sharing Silver-tier plan often should be strongly considered.
Catastrophic Tier (Federal Subsidies are not available in this Tier. You must also be under age 30)
Catastrophic Pathway X 7150 (Anthem) - $40 copay on first three office visits and $7,150 deductible. Once deductible is met, all covered expenses paid at 100%. The maximum out-of-pocket expense is also $7,150. Chiropractor visits are classified as "specialist" visits and are limited to 12 per year. Acupuncture is not covered. Pediatric dental included after deductible is met.
Federal Simple Choice Bronze (CareSource) - $6,650 deductible with $7,150 maximum out-of-pocket costs and 50% coinsurance. Pcp office visit copay is $45 and generic drug copay is $35.
Bronze HMO (CareSource) - $6,650 deductible with $6,850 maximum out-of-pocket expenses and 40% coinsurance. $35 and $75 office visit copays with $100 Urgent Care copay. Generic, preferred brand, and non-preferred brand drugs subject to copays of $25, $100, and $250.
Essential Care 1 (Ambetter) - $6,800 deductible with 100% coverage after it has been met. Good option for healthy persons that don't expect to have a lot of non-preventive claims. If your health changes, you can switch to a more functional policy during the next Open Enrollment. Their complete drug list can be found here.
Bronze Pathway X 7150 - (Anthem)- $7,150 deductible with maximum out-of-pocket expenses of$ 7,150. 0% coinsurance.
MDwise Marketplace Bronze Basic - $6,800 deductible with maximum out-of-pocket expenses of $7,150 and 40% coinsurance. Office visit copays are $30 and $150. Generic and preferred brand drugs are subject to $70 and $140 copays.
Balanced Care 4 (Ambetter) - $30 and $60 office visit copays with $100 copay for Urgent Care. $7,050 deductible with maximum out-of-pocket expenses of $7,050 and 0% coinsurance. $15 and $50 copays on generic and preferred brand drugs.
Low Premium Silver (CareSource) - $30 and $50 office visit copays with $100 Urgent Care copay. $6,150 deductible with $7,000 maximum out-of-pocket expenses and 15% coinsurance. $10 and $50 copays on generic and preferred brand drugs.
Marketplace Gold Plus by MDwise - Low $1,500 deductible with no charge for pcp office visits. Maximum out-of-pocket expenses of $3,500. Adult vision benefits can be added.
Secure Care 1 by Ambetter - $1,000 deductible with three free pcp office visits per person per year. Specialist visits are subject to a deductible.
Gold Value by IU Health Plans - $750 deductible with $20 and $50 office visit copays. Maximum out-of-pocket expenses are $6,000. Generic drug copay is $9.
Gold Pathway X 1500 25 by Anthem - $20 and $50 copays on office visits with $1,500 deductible and low $3,450 maximum out-of-pocket-expenses.
Plan 002 by Assurant - No deductible with $25 copays on office visits. Maximum out-of-pocket maximum is only $2,000 per individual and $4,000 per family. NOTE: Assurant is NOT offering policies in 2016. This plan was previously offered in 2015.
Copay Select by UnitedHealthcare - Low $750 deductible with $15 pcp visit copay and very attractive $30 copay for specialists. Also $8 generic drug copay.
After Open Enrollment Ends
You can apply for coverage after the end of each Open Enrollment period. However, to qualify for a Marketplace plan, you will need a "Special Enrollment Period" exception (SEP). Situations that qualify for this exemption include losing coverage from a divorce, moving to a different service area, termination of an employer-sponsored plan, exhaustion of COBRA benefits, reaching age 26, becoming pregnant, or change in citizenship or immigration status.However, you must convert to a new plan within 60 days or wait until the next OE period.
If you voluntarily terminate or cancel a plan, let your policy lapse, or simply forget to enroll for coverage, an exemption will not be granted. However, you can apply for temporary benefits that can potentially cover large medical expenses until you are eligible for the following Open Enrollment. But during this period, larger potential out-of-pocket expense situations are more likely.
If you don't qualify for an SEP exemption, additional options are available. Simply contact us and we can review the most affordable individual and family health insurance plans in Indiana. Some of these options include non-compliant plans that do not satisfy Obamacare legislation mandates. Thus, although the prices of these policies are quite low, you may have to pay up to 2.5% of your household income as a special tax.
Indiana Medicare Open Enrollment For Seniors
Open Enrollment begins on October 15th and ends on December 7th. However, if you have reached age 65 or are eligible for Medicare, you do not participate or purchase plans through the Marketplace. During these dates, you can change your existing plan and/or your prescription drug coverage. The effective date of the changes would be on January 1st.
If you are currently enrolled in a Medicare Advantage plan, you can change to original Medicare. Your Part D benefits (drugs/prescriptions) can be purchased separately. Medigap (Supplement) coverage may also be offered, depending on your zip code or county. These plans are issued and underwritten by private insurers (Humana, Blue Cross, Aetna, UnitedHealthcare, for example).
There are many more carriers offering products to Seniors instead of persons under age 65. However, plans are standardized and easier to compare benefits. The Centers of Medicare and Medicaid Services, which is controlled by Congress, run the federal program. If you are eligible for Social Security, you can request benefits. Listed below are some of the larger companies that offer coverage:
Issue Age Policies (Premium Does Not Increase Because You Grow Older)
Attained Age Policies (Rate Goes Up As You Get Older)
August 2015 - Indiana's Children's Health Insurance Program (CHIP) received great news. The federal government will pay more than 99% of the plan costs for the next two years. Originally, the reimbursement was going to be approximately 77%. This should help enrollment, which is typically among the lowest (percentage of state population) in the US. The extra revenue is expected to be about $25 million.
Only seven states receive more than 98% reimbursement of CHIP costs. The program is designed for households that make too much money to qualify for Medicaid, but also can not afford private medical plans offered by carriers in their area. More than 8% of children in the state are without coverage.
December 2016 - Anthem continues to lead all carriers in market share and 2017 will not be an exception. However, if you're looking ahead to 2018 and 2019, anticipated changes by President Trump should increase the number of available companies. Perhaps, Cigna, Aetna, and UnitedHealthcare will return.