Indiana Marketplace plans cost a little more in 2020 than the year before. But more than half of the population qualify for subsidies to lower their costs.
Indiana Health Insurance Overview
Among The Hoosier State’s 6.5 million residents, about 2.5 million are enrolled in government-funded programs.1 This group includes Medicaid, with nearly 1.2 million enrollees and Medicare, with close to 1.3 million beneficiaries. A small percentage are enrolled in Marketplace plans.
Indiana and the Affordable Care Act
Indiana’s decision to expand Medicaid to childless adults under 65 led to more people with health insurance. The state accepted Medicaid expansion under the ACA in 2015.3 Since then, more than 447,000 adults gained coverage due to the expansion.4
Buying Indiana Health Insurance for Individuals, Families, and Self-Employed Entrepreneurs
If you don’t have access to medical insurance through an employer, you can get this coverage through an ACA plan. Plans are available to individuals and families. If you’re a self-employed entrepreneur with no employees, you count as an individual.
ACA or Obamacare plans are required to cover preexisting conditions. You can’t be denied a policy because of your health. All plans include essential health benefits, such as prescription drug coverage, hospitalization, and free preventive care. Plans that cover children must also offer them dental and vision coverage.
ACA plans come in four metal levels: bronze, silver, gold, and platinum. Each level covers a certain percentage of your healthcare costs. Bronze covers the least, and platinum offers the most coverage. However, no Indiana health insurance carrier provides platinum plans in 2020.5
Alternative ACA Option: Catastrophic Health Insurance
You can also find catastrophic health plans in Indiana. Only one carrier (Anthem) offers this plan for 2021.6
Catastrophic health insurance is regulated under the ACA. It Includes essential health benefits, but coverage isn’t as comprehensive as regular ACA plans. Catastrophic coverage is designed for major medical events, such as an accident. They’re not ideal for ongoing medical care.
Plans are usually offered to people under 30. But you can get coverage if you’re over 30 and qualify for a hardship exemption. Catastrophic insurance is a type of high deductible health plan that offers low monthly premiums. Premiums are generally lower than standard ACA plans.
Indiana Health Insurance Companies
Two health insurance companies in Indiana offer Marketplace plans for 2021: CareSource Indiana and Celtic Insurance Company aka Ambetter from MHS Indiana. Both carriers offer bronze, silver, and gold plans in all 92 Indiana counties. Another carrier, Anthem Insurance Companies, only offers health insurance plans off the Marketplace.
Indiana Health Insurance Marketplace Enrollment
Indiana uses the federal Marketplace at Healthcare.gov for Obamacare enrollments.
Nearly 141,000 residents signed up for coverage at the end of open enrollment for 2020 coverage. The 2021 Open Enrollment Period (OEP) typically runs from November 1, 2020 to December 15, 2020. Coverage begins on January 1, 2021.
If you miss sign ups, you can still enroll if you have a qualifying life event, such as marriage or relocation. Otherwise, you’ll have to wait until the next OEP.
Special Enrollment Period
Indiana residents who missed open enrollment can sign up for a health plan. The federal government reopened enrollment with a new Special Enrollment Period due to the coronavirus. It runs from February 15, 2021 through August 15, 2021.
How Much Does Health Insurance Cost in Indiana?
Indiana health insurance premiums for most plans are higher in 2020 than the year before.
Below are the average cost for Indiana Marketplace plans:
- Average lowest-cost bronze premium: $310 in 2020; $316 in 2019
- Average lowest-cost silver premium: $381 in 2020; $335 in 2019
- Average lowest-cost gold premium: $534 in 2020; $451 in 2020
How to Get Help With Obamacare Premiums in Indiana
Premium tax credits (called subsidies) help reduce your monthly costs. They’re offered by the federal government when you apply for Marketplace coverage at Healthcare.gov. An individual must earn between $12,760 and $51,040 per year in 2020 to qualify (or 100% to 400% of the federal poverty level [FPL]).
Indiana Medicaid Program for Low-Income Adults and Children
Medicaid is a public health insurance program funded by the state and federal government. About 1.2 million Indiana residents have Medicaid.9 This includes 1 in 8 adults under 65 and 1 in 3 children.
Indiana offers Medicaid to low-income residents, including:
- Children under 19
- Parents and caretakers of minor children
- People who are blind or have disabilities
- Individuals 65 or older
- Pregnant women
Each group has its own Medicaid program and income limits. For example, non-disabled adults 19 to 64 get Medicaid through Healthy Plan Indiana. The income limit for this group is $17,443 a year for an individual as of 2019.
Indiana offers a children’s health insurance program called Hoosier HealthWise. A family of four earning up to $5,633 per month as of 2019 can enroll their eligible children. The program is also available to pregnant women with monthly incomes up to $3,078 for a family of two.
Medicare for Seniors 65 and Older and Younger Adults with Disabilities
There are two main ways beneficiaries get hospital (Part A) and outpatient medical insurance (Part B).
Roughly seven out of 10 Indiana beneficiaries enroll in Original Medicare.12 This is the traditional program run by the federal government. It’s accepted by Medicare providers nationwide.
Many people who enroll buy a separate Medicare Part D prescription drug plan. About 640,000 Indiana beneficiaries bought this plan in 2018.13
Enrollees can also add a Medicare Supplement plan, known as Medigap. Medigap helps pay up some to all Original Medicare out-of-pocket costs, such as deductibles and copayments.
Close to three in 10 Indiana beneficiaries have this plan, which is sold by private insurance companies.14 Policies use provider networks, and most come with Part D drug coverage.
Buying Indiana Short-Term Coverage If You’re In Between Jobs or in a Coverage Gap
Short-term health insurance plans are designed to fill a gap in coverage. For instance, if you’re in between jobs or waiting for benefits to start at a new job.
You typically need to answer health questions to determine if you qualify. If approved, you could get a policy within 24 hours. Keep in mind that these plans don’t qualify as major medical coverage under the ACA. So they aren’t required to cover preexisting conditions.
Short-term plans are usually cheaper than ACA coverage. But you could end up paying more for care in the long run.
Make sure to compare all your Indiana health coverage insurance options before you enroll in coverage.