Just about one out of four Medicare beneficiaries enroll in Medicare Advantage plans in Indiana. Unlike Original Medicare, Medicare Part C in Indiana isn’t standardized, so it’s important to review the co-payments, deductibles, and network rules for each Medicare Advantage plan. A Medicare beneficiary might choose a Medicare Advantage Plan in Indiana to help control the coinsurance costs included with Medicare Part A and Part B and also to enjoy some extra benefits. To learn more specifics, take a moment to read this overview.
Enrolling and Comparing Medicare Advantage Plan in Indiana
To qualify, you must be ready to or have enrolled in Medicare Part A and Part B. The application can only ask one health question about End Stage Renal Disease ESRD, but otherwise, you don’t need to undergo health underwriting. A Medicare beneficiary with ESRD can enroll in a plan tailored to their health needs.
Besides having Original Medicare, you should also pay attention to these enrollment dates:
- Initial Coverage Election Period: You can enroll in a Medicare Advantage plan in Indiana for a few months before and after your first enrollment in Medicare Part A and Part B.
- Annual Election Period: Every year, you get several weeks in the autumn to choose your Medicare Advantage plan for the next year.
- Special Election Periods: If you experience certain changes in your circumstances, you might trigger a Special Election Period at any time of the year.
Note that Medicare also offered a beneficiary a Medicare Advantage Disenrollment Period for the first several weeks of each year. This may be replaced in the future by an extra Annual Election Period.
Once you’ve joined a Medicare Part C plan in Indiana, expect your new insurance company to send you a wallet-sized ID card. Most of the time, you will present this ID card instead of your Original Medicare card when you get health-care services.
Best Medicare Advantage Plans in Indiana
The best choices for a Medicare Advantage plan can vary by your location, budget, and preferences for health-care, so you should take some time to compare and understand your options. You can read these quick summaries of the most common and the best Medicare Advantage plans in Indiana:
Health Maintenance Organization HMO plans
About 28% of enrollment in Indiana MA plans goes to an HMO.
Preferred Provider Organization PPO plans
PPO MA plans are popular in Indiana, with about 72% of total enrollment.
Special Needs Plans SNPs
Insurers also offer Special Needs Plans for a Medicare beneficiary who has to cope with institutional conditions or chronic health conditions.
Dual-Eligible Advantage Plan
People enrolled in Medicare Part A and Part B and Medicaid can enjoy a 0 premium and few out-of-pocket expenses with one of these plans.
Enrollment Statistics for Medicare Advantage Plans in Indiana
These are some important facts about enrollment in Indiana Medicare Advantage plans:
- Total number enrolled in Indiana: 32,274
- Percent of all Original Medicare beneficiaries in India: 26%
These are the most populated counties in Indiana by population:
- Marion County 950,082
- Lake County 485,640
- Allen County 372,877
- Hamilton County 323,747
- St. Joseph County 270,434
How Medicare Advantage Plans in Indiana Cover Prescription Medicine
Medicare Part A and Part B won’t cover most prescriptions. If you only have Medicare Part A and Part B, you will have to pay additional monthly premiums for a Part D plan. Unlike Original Medicare, most Medicare Advantage plans in Indiana do come bundled with drug benefits. These are called Medicare Advantage Prescription Drug plans. To make the best use of your prescription coverage, you should compare the drug benefits offered by various Medicare Advantage plans.
These are a couple of things to look for:
- Plan formulary: A formulary is simply a list of all of the prescriptions that the plan will typically cover.
- Prescription Drug tiers: You may pay different rates or deductibles for different classes of medicine, like brand-name, specialty, and generic drugs.
Network Restrictions for Medicare Advantage Plans in Indiana
With Medicare Part A and Part B, you don’t have any provider networks. Most of the time, you will need to consider the provider network for a Medicare Advantage plan. Insurers use their agreements with a network hospital or doctor to keep rates lower.
To help you understand network restrictions for Indiana Medicare Advantage plans, here are some brief highlights:
- With an HMO, you should count on almost always getting covered trips to a doctor or hospital through the network. These plans may only pay for out-of-network medical services in urgent or emergency situations. You also need a PCP to give you referrals to plan specialists.
- With a PPO Medicare Advantage plan, you can get out-of-network healthcare covered, but you will pay more. You should still plan to visit in-network providers as much as possible. You also don’t need to select a primary care doctor.
Your insurer will have a list of in-network medical providers that they may send you or publish online. You will need to balance the premiums and out-of-pocket costs of any plan with the flexibility and coverage that you get. Any $0 premium Medicare Advantage plans in Indiana are likely to be an HMO.
If you decide to move away from your plan’s service area, you will trigger a Special Election Period. At this time, you an choose a new Medicare Advantage plan in your new city.
Indiana Medicare Resources
If you have enrolled in Medicare Part A and Part B in Indiana, consider these helpful resources from your state: