Indiana medical insurance does not have to cost an arm and a leg. There are many affordable plans that offer benefits that you would expect to find in more comprehensive plans, and the rates may pleasantly surprise you! And if you are currently not covered, or your policy lapsed, there are several very inexpensive “basic” plans available. Many of these options can be purchased outside of the Open Enrollment period.

Our job is to find the policies that allow you to pay the premium that you can afford, but still give you the medical coverage that’s most important to you and you are likely to utilize. For example, if you are currently taking medication for depression, high cholesterol, asthma, or diabetes, often, the cost of a non-generic drug can be quite expensive.If a deductible applies to your RX benefits, the out-of-pocket costs can be very high.

In these situations, we show you the plans that offer the lowest combination of prescription copays and deductibles, to reduce your out-of-pocket cost. Non-generic, generic, and specialty drugs can be covered with discounts applied if you utilize a mail-order option. Depending on your household income, you may qualify for a large subsidy and a cost-sharing Silver-tier plan. The cost of non-generic prescriptions substantially reduces with these types of 2023 plans. Additional resources, including Good Rx, are very helpful.

We do not take any shortcuts. We spend the time needed to research all of your options and never recommend plans that don’t deliver the benefits they promise. By reviewing consumer ratings each year, it helps us determine which plans are most approved by consumers, and which plans should be avoided. Senior Medicare plans often change each year, so a comprehensive review and comparison is recommended.

A Few Of Our Best Tips That Will Help Reduce Your Rate

Let us do the hard work for you. We know it’s time-consuming, confusing and frustrating trying to choose (or even understand) the best healthcare policies (on or off the Exchange). But by providing the information needed for a quote, you’ll be presented with the best options in an easy to understand format. You will also have a live person to talk to or email any time, including after you purchase a policy. Generally, you can talk to a live person until midnight.

We also explain the impact of recent legislation, or changes to existing laws. Although many changes only impact Seniors and Medigap plans, many other new regulations will affect persons under age 65. Medicaid and CHIP eligibility may also be impacted, depending upon your household income. If your child is a college student, we compare private and University-sponsored plans to determine your best choice. Many schools offer supplementary products that can reduce out-of-pocket expenses.

If you qualify for a federal subsidy, always consider the “Silver-Tier plans. Why? Because Silver Metal plans are the only policies that offer “cost-sharing.” Depending on your income, the deductible and co-payments could substantially reduce. Maximum out-of-pocket expenses (MOP) can also reduce, resulting in thousands of dollars of savings if you meet your deductible. This type of savings does not affect persons eligible for Medicare or Medicaid. All other tiers do not offer the cost-saving feature.

For example, a family of five persons (husband and wife in their 40s) will qualify for an instant federal tax credit of about $11,000 per year. A $3,500 major medical deductible can reduce to $800 with primary-care physician and specialist office visit copays also reducing. Although other plans will receive the same subsidy, the best “value” comes from Silver-Tier contracts. Bronze-tier plans will be less expensive, but provide significantly higher out-of-pocket costs, and often a deductible on specialist visits. Gold and Platinum-tier plans may have substantially higher premiums.

Don’t Miss Open Enrollment. The under-65 Open Enrollment period begins November 1st and ends December 15th. During this time, no medical questions are asked when you purchase a Marketplace or qualified off-Exchange plan. If you are being treated for a serious medical condition, it is critical to apply for coverage during these dates. Otherwise, although plans may be offered, pre-existing conditions probably will not be covered.

Senior Medicare Open Enrollment begins October 15th and ends December 7th.During this time, you can select Supplement, Advantage, and Part D plans. You also may be able to change from one type of plan to another. If you miss the deadline, you must keep your existing plan, although you may be able to change during the next Open Enrollment period.

Rates for Part D prescription drug plans will greatly vary. For example, for 2022, the least expensive plans are SilverScript SmartRx ($6.80 monthly) and Wellcare Value Script ($12.90 monthly). The most expensive plans are AARP MedicareRx Preferred ($92.50 monthly) and Mutual Of Omaha Rx Plus ($76.00 monthly).

Be Careful With What You See On TV

Don’t buy health insurance from a TV commercial. Many of the ads are “limited benefit” plans that will provide much less coverage than you need. Many Hoosier residents have found out the hard way, when only $4,000 of their $25,000 hospital bill is covered. Many of those plans are also not classified as “insurance.” They are only “discount plans,” which have very basic coverage, and are not subject to ACA Legislation regulations.

Subsidies can not be used, and many claims will be challenged. Also, a large application fee ($75-$200) may be required prior to enrollment. Exchange and Group plans have no enrollment fee or required association to join. Temporary plans often have smaller fees of $15-$50, although they are non-refundable.

And if you have a claim, you’ll realize how limited your benefits are, and how difficult it is to obtain a refund on any money you already paid, including an application fee. Please avoid these contracts, especially if you are contacted by someone that insists you immediately purchase a policy because of a “deal” that mysteriously expires within 24 hours. Often, the offers are made via a phone call.

If you think you are paying too much, maybe you are! Medical benefits in Indiana are not nearly as expensive as in many other states. Have you recently checked the rates in New Jersey, New York or Massachusetts? Prior to 2014, the longer you stayed with a specific company, the more competitive the rate became. This is no longer true, since applicants can freely switch plans each year.

Should You Stay Or Switch?

Sometimes, staying with the same company may actually work against you, although each situation is different. If you are being treated for cancer or another serious illness, although you can change plans and carriers during Open Enrollment, it may not be the best choice for that particular time. Retaining your current doctor, hospital, and other medical facilities, is a very justified concern.

However, if no household member is currently being treated for a medical condition, and you have been insured with the same company for more than three years, it may be a good time to view current quotes (see quote box at the top of the page) if the premium is constantly increasing. Other plan alternatives may be more cost-efficient, although we do not recommend cancelling a current plan until we have reviewed all options and calculated your federal subsidy (if you qualify) for the upcoming year.

Understand Your Coverage

It is important to review the terms, conditions and possible limitations of the newly issued coverage. A live broker can help you (upon request from our website). A “non-compliant” policy will omit specific benefits, so it’s important to understand which type of policy you are purchasing. Generally, it is not beneficial to change from a compliant on (or off) Exchange plan to a policy that is not ACA-approved.

Note: A short-term plan will be approved within hours but should not be a long-term cure for your needs. Unless you missed Open Enrollment, or completely comprehend the limitations of temporary coverage, they should not be utilized. Legislation of temporary plans may also change within the next several years. The American Medical Association is also a very reliable resource for examining the impact of legislation on medical coverage.

Do not pay for coverage that you probably will not use. Previously, the biggest offender was maternity coverage. Maternity benefits are VERY expensive. You probably did not have this benefit if you purchased an individual policy prior to the ACA. But if you were paying for maternity benefits, the cost was in excess of $4,000 per year.

NOTE:  Most “grandfathered” plans (see below) have been replaced by new compliant contracts. Maternity benefits are automatically included without a waiting period or excess surcharges for complicated deliveries. The newborn can automatically be added to existing policies or covered on a new contract.

Grandfathered Plans

A “grandfathered” policy allows you to exclude many benefits you may never utilize (such as maternity). A policy qualifies for a “grandfathered” status if it was issued on or before March 23, 2010 and there were no major modifications or changes to the policy. A change to the deductible, coinsurance, or elimination of riders would constitute a “major modification.”

However, at any time, the insurer can terminate these plans and you would then be forced to purchase an Exchange policy that did contain mandatory maternity coverage. Typically, there is a window that allows you to properly compare all of the available options. If you are eligible, a large federal subsidy could reduce your rate.

Low deductibles will drastically increase your premium. If you rarely (if ever) meet your deductible, raising maximum out-of-pocket limits can potentially save you thousands of dollars each year. Yes…you do take on more risk and you will have to weigh the risk vs. the potential money you will save. But if you’re looking ahead a bit (maybe 3-10 years), you may save thousands of dollars that will easily offset the extra money you paid.

Review

Our software constantly updates Indiana premiums (usually daily) so the information you view is very current. We also try to make it very easy to view your options. You will notice there are fields at the top of the page where you can request your free quote. You might be surprised at how many affordable policies are available, and how quickly your enrollment is processed.