Archive for the ‘Indiana Health Insurance’ Category

Indiana Health Insurers File For 2017 Rate Increases In Marketplace

How much will health insurance in Indiana cost in 2017?  Every company that is licensed to offer Marketplace plans has completed and submitted their rate request to the Department of Insurance. We have summarized the requests below. Open Enrollment begins November 1st and ends January 31st 2017. Future OE periods will be smaller (45 days). Also, several carriers that currently offer coverage (Anthem, Indiana University Health Plans, and MDwise) are not offering 2018 or 2019 Marketplace plans.


Advantage Health Solutions

25.00% – HMO Small Group



4.57% – Fee-For-Service Small Group

8.76% – PPO Small Group


All-Savers Insurance Company

-.02% – Small Group


Anthem BCBS

-4.59% – HMO Off Exchange Small Group

4.35% – POS On Exchange Small Group

-1.85% – HMO On Exchange Small Group

33.79% – POS Off Exchange Individual

29.78% – HMO MSP Individual

28.28% – HMO Individual

32.79% – POS Individual

28.58% – HMO Off Exchange Individual



16.14% – HMO Basic Individual

13.41% – HMO Enhanced 2015 Individual


Celtic (Ambetter)

-5.51% – Ambetter Individual

-4.40% – Ambetter Vision + Adult Dental Individual

-5.24% – Ambetter + Vision Individual


Federated Mutual

15.49% – Small Group



8.43% – Small Group

1.13% – HMO Small Group

7.62% – Indemnity Small Group

6.96% – PPO Small Group


Indiana University Health Plans

9.39% – Marketplace Plus

5.03% – Small Group Product

-25.38% – POS Small Group

4.46% – SG POS Small Group

10.60% – Individual Product



11.47% – Marketplace Individual

12.01% – MarketplacePlus  Individual With Adult Vision


National Health Insurance Company

9.76% – Nationcare Small Group


Physicians Health Plan (PHP)

6.03% – Small Group HMO

6.58% – Small Group POS


US Health And Life

3.12% – HSA Small Group

4.13% – PPO Small Group



1.60% – PPO Small Group

1.60% – PPO With Morbid Obesity Small Group

5.50% – EPO With Morbid Obesity Small Group

4.25% – Choice Plus Small Group

9.25% – Choice Small Group

2.15% – POS With Morbid Obesity Small Group

Vice President Mike Pence – If Elected, Here Is What To Expect

Indiana Governor Mike Pence has a great chance to become the nation’s next Vice-President, as Donald Trump and Hillary Clinton campaign for America’s votes.  If the Trump/Pence ticket wins in November, you can expect several changes to occur within the first 100 days of the Presidency.

Enjoy our tongue and cheek “Top 10” list below of the positive changes that a Donald Trump/Mike Pence ticket will bring to Indiana.


Pence Trump Ticket

Can Mike And Karen Pence Make It To The White House?


Indiana will become  great again! Unemployment will drastically reduce, and Caterpillar, Proctor And Gamble, Ford, and Microsoft will all move their home offices to the Hoosier State, creating more than 100,000 new jobs. The State income tax will be eliminated, although a new 22.4% beverage and food tax will be initiated. Naturally, this tax will rise with inflation each year.


Financially-strapped Kentucky will disband, and become part of  the new “Greater Indiana.”  Larger cities in the state will also officially change their name. For example, Louisville, will now be known as Fort Wayne, and Lexington will be known as Indianapolis. And of course, the Kentucky Derby will change their name to “The Great Hoosier Race.”  The University of Kentucky Wildcats will change their name to the “Mildcats,” unless they beat either Florida or Alabama in football.


Obamacare will be repealed and replaced by state-specific programs. Indiana’s state healthcare program will be called “PenceCare,” and will require all residents to abstain from diet soda, and have four complete physicals each month. All prescriptions will be free, and to reduce expenses, in-hospital stays will be shared with six other patients in your room. And to increase popularity of the program, Indiana Marketplace health insurance plans will include free autographed pictures of Donald Trump. If President Trump is impeached or not re-elected,  the distributed pictures will be collected.


The winner of the Indianapolis 500 will be invited to the White House for an official recognition ceremony. The drive from Indiana to Washington D.C. usually takes about nine hours along Interstate 70 and other highways. Because the actual winner will be driving, and the complete route will be temporarily closed to the public, the trip should take less than three hours, with top speeds reaching more than 200 miles per hour. Six pit stops are expected. The average time of each pit stop is expected to be less than 30 seconds.


A new “Pence Tower” (modeled after the “Trump Tower”) will be built in Richmond. Costing more than $2 billion, the 95-story complex will include hotel rooms, a small basketball arena, two entertainment centers, a bull-fighting ring, and 27 restaurants. Room rates will cost between $950 and $10,000 per day, depending upon the size of the pool, which every room will have. Naturally, WiFi and cable tv will be included.

Bob Knight Indiana Hoosiers

Coach Bob Knight Will Make A Triumphant Return To Bloomington

The National Hockey League (NHL) will award  a franchise to Bloomington, with the team named the “Knight Red Sweaters.” And yes, Bob Knight will be the inaugural General Manager in charge of player development, contract negotiations, and chair-throwing. All fans will receive  a 25% discount on food and drinks, if they wear a red sweater to home games. Any fan wearing a green sweater will be escorted out of the arena.


Nintendo will release the sequel to its ultra-successful game Pokemon Go. Titled “Pence Go,” the new game will be similar to its predecessor with a few changes. “Pence Go” players will receive health insurance deductible credits for every Pokemon that is captured, and  2,500 new PokeStops will be created in random locations within the Hoosier State. There will be no cost for playing the game, although excessive participation can result in a fine from the Department of Health and Human Services (HHS). The fine, however, is tax-deductible.


The movie “Hoosiers” will be played at all White House functions, including weddings, inaugurations, and foreign dignitary visits. A special trivia contest will be enjoyed by all White House visitors, and a free iTunes download will be offered. The epic movie from 1986 also will also be shown on all Air Force One flights and a large picture of Gene Hackman will be painted on both sides of the plane.


A 17-story statue of Mike Pence will be erected in Columbus, where Mike was born in 1959. It will be a beautiful structure with multiple restaurants, office space, meeting rooms, and hotel accommodations able to fit inside the statue. One big problem though. The monstrosity is accidentally built in Columbus, OHIO, and not Columbus, INDIANA. Whoops. After months of negotiations, several structural changes are made, and the building suddenly resembles Ohio State Football Coach Urban Meyer, instead of Pence. And of course, Ohio State continues to beat Indiana in football.


The Pence Candy bar will begin full production, with distribution expected into most Midwestern States by March of 2017. The  two-ounce candy bar will sell for $1, and be available in most grocery stores. In an effort to reduce calories and fat, chocolate will be replaced by bean sprouts, and sugar will be replaced by a combination of pepper, thyme, and cinnamon. The awkward taste is recognized on the popular TV show “Bizarre Foods.”

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


Community Hospital South

Community Hospital North

Heart and Vascular

Community Hospital East

Hendricks Regional

Johnson Memorial


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.