Just about one out of four Medicare beneficiaries enroll in a Medicare Advantage plan 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 for 2022 to help control the coinsurance costs included with Medicare Part A and Part B and also to enjoy some extra benefits, such as Medicare Part D prescription drug coverage. To learn more specifics, take a moment to read this overview.
What is Medicare Advantage in Indiana?
If you are enrolling in Medicare Part A, Medicare Part B and a Part D plan, you may be interested in a Medicare Advantage plan in Indiana that bundles all three parts under one plan.
When you sign up for a Medicare Advantage plan in Indiana in 2022, your enrollment in Original Medicare continues, but most of the benefits that fall under Part A and Part B will be administered by your Indiana Medicare Advantage plan, also known as Medicare Part C.
- Medicare Advantage (MA) insurance plans are sold by Medicare-approved private health insurance companies.
- An Indiana Medicare Advantage plan that includes prescription drug coverage is referred to as a Medicare Advantage Prescription Drug Plan (MAPD).
- You are responsible for staying current with your Part B premiums, separately from monthly premiums due to the insurance company that issued the insurance plan.
- To reap the most benefits from MA plans, you would typically have to use a primary care physician and other healthcare providers from within the plan’s network.
Although some Medicare beneficiaries would prefer not to be limited to network providers, Indiana Medicare Advantage plans are becoming increasingly popular.
One reason is that these health plans often cover extra benefits, including:
- Wellness programs
- Transportation to and from health care providers
- Over-the-counter drugs, wellness and medical-related products
What is the Best Medicare Advantage plan in Indiana in 2022?
There are several types of MA plans. The most common types and the features that generally apply to each are described below. Our insurance agents can review coverage options with you and confirm provisions for the plan you select.
Best for lowest out-of-pocket: Medicare Advantage HMO Plan
Health Maintenance Organization (HMO plans):
- Restricts coverage to health care services provided by network providers except for emergencies
- Requires a referral to see a specialist, with few exceptions
- Usually no premium
Best network freedom: Medicare Advantage PPO
Preferred Provider Organization (PPO plans):
- Larger network than HMO and allows the option of using out-of-network providers at a higher out-of-pocket cost
- Does not require referrals
- Charges monthly premiums ranging from $0 to $100
Best for low income or health conditions: Medicare Advantage D-SNP
Dual Eligible Special Needs Plan (D-SNP):
- An SNP is a plan designed for people with specific health care needs or limited financial resources.
- D-SNP is an SNP for dual eligibles – beneficiaries covered by both Medicare and Medicaid – where benefits are coordinated between the two agencies to lower out-of-pocket costs (deductibles, copayments and coinsurance).
- Benefits are tailored to the recipient’s needs, which helps to further reduce out of pocket costs.
What Medicare Advantage plans are available in Indiana for 2022?
Number of MA plans available in Indiana for 2022:
- Local HMO: 46
- Local PPO: 35
- Regional PPO: 3
How much does Medicare Advantage cost in 2022?
The availability and cost of an MA plan varies from county to county. In 2022, the average monthly premium for an MAPD plan in Indiana is $20.88.
When can I make changes to my Medicare Advantage plan?
Generally, you are locked into a 12-month period when you sign up for an MA plan. If you do need to make changes, the Medicare Advantage Open Enrollment Period (January 1 – March 31) is your primary opportunity to:
- Switch to another MA plan
- Go back to Medicare coverage under Original Medicare
If you have an MAPD, you can:
- Change to another MA plan with or without prescription drug coverage
- Join a Medicare drug plan if you drop your MAPD plan and go back to Medicare coverage under Original Medicare
When can you enroll in a Indiana Medicare Advantage plan for 2022?
Initial Enrollment Period
When you first become eligible to sign up for Original Medicare (Medicare Part A and Part B), you can enroll in Medicare Advantage. Eligibility is generally when you turn 65. You have seven months from three months before your birthday month until three months after.
Open Enrollment Period – aka Annual Election Period
- October 15 through December 7
- Can join, change or terminate plan
- January 1 coverage effective date
Medicare Advantage Open Enrollment Period
- January 1 through March 31
- Open to MA members only
- Can switch to another MA plan or revert to Medicare coverage under Original Medicare
- Can join Medicare Part D (prescription drug plans)
During this time, beneficiaries who get Medicare coverage from Original Medicare cannot:
- Join an MA plan
- Enroll in Part D
- Change prescription drug plans
Special Enrollment Periods – Special Circumstances
If you have group health insurance through employment and delayed signing up for Part B, this period applies to you. From the month following the end of employment or coverage, whichever occurs first, you have eight months to sign up.
Employment may be:
- Your own employer
- Your spouse’s employer
- A family member’s employer, if you have a disability
5-star Special Enrollment Period
Medicare rates plans on a scale of one to five stars with five representing excellent quality and performance. During this special enrollment period, you can change your current plan to one that has five stars if available in your service area.
- December 8 through November 30
- Change can occur only once during this time frame
Special Enrollment Periods if you get “Extra Help”
Extra Help is a program that helps beneficiaries who have restricted financial resources. Extra Help beneficiaries can join, change or drop Medicare Advantage or Part D once within each period:
- January through March
- April through June
- July through September
Are Medicare Advantage plans in Indiana “bad”?
Medicare Advantage plans in Indiana are rising in popularity. This can be attributed to the convenience of having Part A, B and D bundled under one insurance plan as well as additional coverage that extends beyond Original Medicare.
This is reflected in the 9.6% increase in MA enrollment across the county from 2021 to 2022. The growth rate in Indiana averaged 15%.
Number of enrollees in Medicare Advantage in Indiana: 350,408
Number of enrollees by type of Medicare Advantage plan:
- Local HMO: 112,584
- Local PPO: 194,984
- Regional PPO: 40,552
Percentage of enrollees in Medicare Advantage in Indiana: 39%
Number of enrollees in Medicare Advantage nationwide: 19,838,319
Percentage of enrollees in Medicare Advantage nationwide: 42%
Frequently Asked Questions about Medicare Advantage in Indiana
What's the downside to Medicare Advantage plans?
- Requires use of network providers and referrals
- Responsible for coinsurance, copays and deductibles
- Requires your participation on an ongoing basis: confirming doctors are in network, paying bills for copays and coinsurance, and decision making every time plan announces changes
- Need to reevaluate plan annually to ensure it is still the best plan for you, unlike Medicare Supplement plans (Medigap), which continue unchanged from one year to the next
What are 4 types of Medicare Advantage plans in Indiana?
Most common MA plans:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-for-Service (PFFS)
- Special Needs Plan (SNP)
What are the top 3 Medicare Advantage plans in 2022?
- United Healthcare
- Blue Cross Blue Shield
What Are Medicare Special Needs Plans?
- SNPs are structured for beneficiaries with singular health care needs that require specific benefits, prescription drugs, providers and coordination of care.
- Eligibility includes people who live in nursing homes and people who have severe or disabling health issues like diabetes, end-stage renal disease, chronic heart disease, dementia and HIV/AIDS.
- People with limited incomes – beneficiaries with both Medicare and Medicaid – are qualified to enroll.
Does Medicare Advantage cover drugs?
MAPD identifies Medicare Advantage plans that cover prescription drugs. Drug coverage is one of the attributes that differentiates MA plans from Medigap. If you have a Medigap policy, you have to purchase a Part D plan separately.
Do Medicare Advantage plans use the SilverSneakers program in Indiana?
Some MA plans partner with SilverSneakers to promote fitness. If this is not an option, ask what other wellness offerings your plan has.
Indiana Medicare Resources
Ready to Learn More?
Medicare can be very confusing, if you need help on plan selection or getting more detailed information, please reach out to us for additional help, we are here to guide you!