Indiana Health Insurance

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

The Hoosier State’s 6.8 million residents get their health coverage and insurance from a variety of sources. Employer insurance is number one followed by government-funded programs like Medicare and Medicaid. About one in 20 residents choose to get insurance themselves through the Health Insurance Marketplace or directly from insurers.

Indiana and the Affordable Care Act

The Affordable Care Act or Obamacare took effect in 2013. About 900,000 Indiana residents were uninsured at that time compared to 570,000 as of 2019. That’s a drop from a 14% uninsured rate to 9%.¹

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 2015.²  Since then, more than 447,000 adults gained coverage due to the expansion.³

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 2020.⁴

Alternative ACA Option: Catastrophic Health Insurance

You can also find catastrophic health plans in Indiana. Only one carrier (Anthem) offers this plan for 2021.⁵

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 

Four health insurance companies in Indiana offer Marketplace plans for 2022:

• Anthem Insurance Companies (plans offered in 45 counties)
• CareSource Indiana (plans offered in all 92 counties)
• Celtic Insurance Company aka Ambetter from MHS Indiana (ACA plans offered in all 92 counties)
• US Health and Life Insurance Company (first year, plans offered in 30 counties)

Indiana Health Insurance Marketplace Enrollment

Indiana uses the federal Marketplace at Healthcare.gov for Obamacare enrollments.

Nearly 125,000 residents signed up for coverage at the end of open enrollment for 2020 coverage. The 2022 Open Enrollment Period (OEP) typically runs from November 1, 2021 to January 15, 2022. Coverage begins on January 1 if you enroll by December 15.

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.

How Much Does Health Insurance Cost in Indiana?

Indiana health insurance premiums for most plans are higher in 2021 than the year before.

Below are the average cost for Indiana Marketplace plans:

• Average lowest-cost bronze premium: $333 in 2021; $310 in 2020
• Average lowest-cost silver premium: $400 in 2021; $381 in 2020
• Average lowest-cost gold premium: $592 in 2021; $534 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.

Before 2021, if you earned between one to four times of the federal poverty level, you were eligible for subsidies to help you pay for any metal plan.

In 2021, the federal government expanded subsidies and removed the income cap for premium tax credits. Instead, you would pay no more than 8.5% of your annual household income on health insurance based on the price of the benchmark plan. The federal government would cover the balance through subsidies. 

Seventy-one percent of Indiana Marketplace enrollees received premiums tax credits in 2020.⁶ The average subsidy received at this time was $394 per month.

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.⁷ 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 $17,780 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 $5,521 per month as of 2021 can enroll their eligible children. The program is also available to pregnant women with monthly incomes up to $3,093 for a family of two.

You can view all Indiana Medicaid Programs here. 

Medicare for Seniors 65 and Older and Younger Adults with Disabilities 

Medicare enrolls close to 1.3 million Indiana residents.⁸ The majority (83%) qualify when they turn 65. The remaining are adults under 65 with disabilities.⁹

There are two main ways beneficiaries get hospital (Part A) and outpatient medical insurance (Part B).

Original Medicare

Roughly seven out of 10 Indiana beneficiaries enroll in Original Medicare.¹⁰ 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 2018.¹¹ 

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. 

Medicare Advantage

Close to three in 10 Indiana beneficiaries have this plan, which is sold by private insurance companies.¹² 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

As of July 2019, Indiana allows short-term coverage for up to 12 months with renewals up to 3 years.¹³

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.