Finding Medicare Plans in Indiana
Indiana offers a variety of Medicare options, but, selecting the right coverage for your needs can feel overwhelming. We’ll help you sort through your options and select the Medicare coverage that’s right for you.
What is Medicare?
Medicare is federal health insurance program for people 65 and older and certain people under the age of 65 who have a qualifying disability. Medicare isn’t intended to pay for all medical expenses; Medicare beneficiaries still pay a portion of their medical bills through coinsurance, deductibles, and copayments.
There are four parts of Medicare:
Original Medicare Part A and Part B
Original Medicare is the federal portion of the Medicare program and has two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, hospice, and care received at a skilled nursing facility.
Part B (Medical Insurance) covers outpatient medical services, like ambulance services, and durable medical equipment, like blood sugar monitors, walkers, and wheelchairs. Part B also covers some preventive care services, like flu shots, cardiovascular screenings, and a one-time “Welcome to Medicare” preventive visit.
It’s important to note that Original Medicare doesn’t cover everything. Some areas that Original Medicare typically does not cover include:
- Prescription drugs
- Hearing exams and hearing aids
- Long term care (i.e. care received at a nursing home)
For this reason, there are Medicare plans available through Medicare-approved private insurance companies to help you find the coverage you need.
Medicare Advantage Plans (Part C)
Medicare Advantage plans are available through private insurance companies, approved by Medicare. These plans work as an alternative to the coverage provided by Original Medicare. Part C plans must include the same benefits as Original Medicare, but they often include additional benefits, such as dental and vision coverage. There are also Medicare Advantage Prescription Drug (MAPD) plans, which also provide prescription drug coverage.
To qualify for a Medicare Advantage plan, you must first be enrolled in both Parts A and B. If enrolled, you’ll continue to pay your Part B premium along with your new Part C premium.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug plans (also known as Medicare Part D) provide coverage for prescription medications, which isn’t covered by Original Medicare nor Medigap plans. Medicare Part D is provided and coordinated by private insurance companies contracted with Medicare. Out-of-pocket costs for prescription drugs and monthly plan premiums vary from plan to plan. Prescriptions are put into tiers, each tier having a certain copay or coinsurance. Each plan provides a drug formulary, so you can see which tier(s) your medications fall into and the out-of-pocket costs associated. This way, you can select the plan with the best value for your prescription needs.
Any beneficiary can sign-up for Medicare Part D, provided that they are eligible for Original Medicare, Part A and/or Part B and permanently reside in the service area of a Medicare Prescription Drug Plan. Medicare Prescription Drug coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you could pay a late-enrollment penalty if you enroll later.
Medicare Part D comes in the form of a stand-alone Medicare Prescription Drug Plan, which work alongside Original Medicare, or with a Medicare Advantage plan that provides prescription drug coverage (also known as a Medicare Advantage Prescription Drug Plan).
Medicare Supplement Plans (Medigap)
As we mentioned earlier, Medicare beneficiaries are still responsible for paying a portion of their Medical bills through deductibles, copayments, and coinsurance. This is where Medicare Supplement, also called “Medigap”, plans come in. Medigap plans work alongside your Original Medicare to pay for certain things that Original Medicare doesn’t cover. If you plan to continue with Original Medicare, a Medigap plan could help to reduce your out-of-pocket expenses.
Am I eligible for Medicare in Indiana?
To qualify for Medicare, you must be eligible for Social Security benefits. Most people become Medicare-eligible once they reach 65 years of age, but certain people under 65 may also qualify. If you are under 65, you may qualify for Medicare if you have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD). You may also qualify if you have been a recipient of Social Security Disability Insurance (SSDI) for 24 months.
In order to qualify, you must be a citizen or permanent resident, having lived in the US for at least 5 years. You or your spouse must also have worked in a job for 10 years that paid towards your Medicare coverage through Social Security deductions.
If you have questions about your eligibility or options, you can speak to a licensed insurance agent by calling the number above.
What are the Medicare Enrollment Periods in Indiana?
Medicare Advantage and Medicare Prescription Drug Plans
Your Initial Enrollment Period (IEP) is a seven-month period that starts three months before your 65th birthday month. This IEP is your first opportunity to enroll in Medicare.
You can then enroll in a Medicare Advantage or Medicare Prescription Drug plan during the Annual Election Period (AEP). The AEP occurs every year from October 15th to December 7th.
Key Fact: The General Enrollment Period (GEP) allows you to enroll in Original Medicare if you missed your IEP. This period occurs from January 1st to March 31st every year. Immediately following this period, you’ll be able to select a Medicare Advantage plan from April 1st to June 30th each year.
Medicare Supplement Plans
Once you’ve enrolled in both parts of Original Medicare Parts A and B, you can select the Medigap plan of your choice during your Medigap Open Enrollment Period. This 6-month period begins the month you are both 65 or older and enrolled in Medicare Part B.
Important Note: If you fail to enroll in a Medigap plan during your Medigap Open Enrollment Period, you’re subject to higher premiums or denial of coverage entirely.
Special Enrollment Periods
Some major life changes, like moving into a new coverage area or transferring to or from a care facility, are qualifying life events for a Special Enrollment Period (SEP). An SEP allows you to enroll or make changes to your coverage outside of the standard enrollment periods. Our licensed insurance agents can help determine your eligibility for a Special Enrollment Period.
How Can I Compare Plans?
If you’d like to compare your options or need help looking through your options, we can help. You can compare plans online by using the form below or by calling us and speaking with a licensed insurance agent.
Additional Medicare Resources in Indiana
The State Health Insurance Assistance Program (SHIP) provides free, confidential, and unbiased counseling for Medicare beneficiaries in Indiana, their representatives, and those who will be eligible for Medicare soon.
Indiana’s Medicare Savings Program provides financial assistance to Medicare beneficiaries whose income falls below a certain level to help pay for medical expenses, like premiums and deductibles.
Sources: Medicare.gov; www.in.gov