Medicare is a federal health insurance program available to people age 65 and older, as well as to those under 65 years old who have certain chronic health conditions or disabilities.
If you’re new to Medicare, it’s not always easy to figure out your coverage options. This article offers an introduction to Medicare Indiana, including how to choose a plan that’s right for you.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Indiana for the 2021 plan year:
- A total of 1,280,707 residents of Indiana are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in Indiana compared to last year — from $17.81 in 2020 to $16.07 in 2021.
- There are 126 Medicare Advantage plans available in Indiana for 2021, compared to 94 plans in 2020.
- All Indiana residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Indiana for 2021.
Medicare plans in Indiana have four parts:
- Part A, which is hospital inpatient care
- Part B, which is outpatient care
- Part C, also known as Medicare Advantage
- Part D, which is prescription drug coverage
When you turn 65 years old, you may sign up for original Medicare (Part A and Part B) and add on any additional coverage from there.
Part A coverage includes:
- coverage when you’re admitted to a hospital for short-term care
- limited coverage for short-term skilled nursing facility care
- some part-time home healthcare services
- hospice care
Part B coverage includes:
- doctors’ visits
- preventive care and screenings
- imaging and laboratory tests
- durable medical equipment
- outpatient treatments and services
After signing up for original Medicare, you can decide whether you want a Medicare Advantage plan or a Medigap plan, as well as prescription drug coverage.
Medicare Advantage in Indiana
Private insurance carriers offer Medicare Advantage (Part C) plans in Indiana that bundle the benefits of original Medicare with prescription drug coverage and other services, such as dental or vision care. Specific coverage varies by plan and carrier.
Another benefit of Medicare Advantage plans is the annual out-of-pocket spending limit. Once you reach the yearly limit set by the plan, your plan pays the rest of your Medicare-approved costs for covered care for the year.
These insurance carriers offer Medicare Advantage plans in Indiana:
- Anthem Blue Cross and Blue Shield
- Anthem HealthKeepers
- Indiana University Health Plans
- Lasso Healthcare
- Zing Health
Different plans are available in each Indiana county, so your options depend on where you live and your ZIP code. Not all plans are available in every area.
Medicare supplement plans in Indiana
Medigap can help pay out-of-pocket expenses. There are 10 Medigap “plans” that offer coverage: A, B, C, D, F, G, K, L, M, and N. Each plan has slightly different coverage, and not all plans are sold in every area. Consider your individual needs when reviewing Medigap plans.
Many companies offer Medigap plans in Indiana. In 2021, some of the companies offering Medigap plans throughout the state include:
To be eligible for Medicare Indiana plans, you must:
- be 65 years old or over
- be a U.S. citizen or a legal resident for 5 years or more
You may qualify before you’re 65 years old if you:
- received Social Security Disability Insurance (SSDI) or Railroad Retirement Benefits (RRB) for 24 months
- have end stage renal disease (ESRD) or a kidney transplant
- have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
When can I enroll in Medicare Indiana plans?
If you’re eligible for Medicare, you can sign up at certain times during the year. These times include:
- Initial enrollment period. If you’re first eligible when you turn age 65, you can sign up during this 7-month period. It starts 3 months before the month you turn age 65 and ends 3 months after the month of your 65th birthday.
- Medicare open enrollment period. The annual open enrollment period happens between October 15 and December 7. At this time, you can join a Medicare Advantage plan or switch to a new plan.
- Medicare Advantage open enrollment period. If you’re already in a Medicare Advantage plan, you can switch to another one between January 1 and March 31 every year.
Certain life events, such as losing a job that provides you with health coverage, will trigger a special enrollment period. This gives you an opportunity to sign up for Medicare outside of the standard enrollment periods.
In some cases, you may be signed up for Medicare automatically. If you’re eligible because of a disability, you’ll get Medicare after you’ve received 24 months of Social Security Disability Insurance. You’ll also be signed up automatically when you turn age 65 if you’re already getting Social Security retirement benefits.
Tips for enrolling in Medicare in Indiana
It’s important to evaluate your healthcare needs and read each plan carefully so you can choose the one that offers the best coverage for your needs. Carefully consider:
- whether you need original Medicare or Medicare Advantage
- if your preferred doctors are in the Medicare Advantage plan’s network
- what the premium, deductible, copay, coinsurance, and out-of-pocket costs are for each plan
To avoid the late enrollment penalty, sign up for all parts of Medicare (A, B, and D) or make sure you have other coverage, like an employer-sponsored plan, when you turn age 65.
If you need more information or help understanding your Medicare options in Indiana, these resources are available:
- More than 1.2 million Indiana residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in Indiana.
- There are also several Medigap plan options if you live in Indiana and are looking for additional coverage.