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Medicare Advantage in Indiana

As a Medicare beneficiary in Indiana, you may opt to sign up for Medicare Advantage (Medicare Part C). Medicare Advantage is private insurance, and it allows you to receive your health benefits through a private health plan rather than directly through Medicare. Plan availability may depend on your zip code.

How Medicare Advantage works in Indiana

The government requires Medicare Advantage in Indiana to offer at least the same medical and hospitalization benefits available under Original Medicare, Part A and Part B. In addition, some Medicare Advantage plans in Indiana may offer extra benefits, such as prescription drug coverage and dental services.

To qualify for a Medicare Advantage plan in Indiana, or in any state, you must already be enrolled or be eligible to enroll in Original Medicare, Part A and Part B. You need to live in the plan’s service area, and in most cases you cannot have end-stage renal disease.

There are several election periods for Medicare Part C.

Your Initial Coverage Election Period (ICEP) is when you’re first eligible to enroll.

  • In most cases, this time period is the same as your Initial Enrollment Period (IEP), which begins three months before you turn 65, includes your birthday month, and ends three months after your birth month.
  • If you’re 65 or older and choose to delay enrollment in Medicare Part B (for example, if you’re covered by employer-based health insurance), your ICEP will begin three months before your Part B start date. For example, if you signed up for Medicare Part B during Medicare’s General Enrollment Period (January 1 to March 31), your Part B start date would be July 1, so your ICEP would be April 1 through June 30.

If you missed your ICEP, you can sign up for a Medicare Advantage plan in Indiana, or switch to a different Medicare Advantage plan, during the Annual Election Period. Also called the Fall Open Enrollment season, it runs from October 15 to December 7. Your new coverage goes into effect on January 1 of the following year. You may be able to make other changes to your Medicare coverage at this time, such as (but not limited to) adding or dropping prescription drug coverage. Since most Medicare Advantage plans include drug coverage, in most cases you can’t add this coverage to a Medicare Part C plan.

In certain situations, you may be allowed to switch Medicare Advantage plans during Special Election Periods. Those circumstances include, among others: losing your current coverage; moving to a new address where your old plan isn’t available; qualifying for other coverage; or experiencing changes in your current plan that affect your health benefits. Special Election Periods in Indiana, as in all states, vary according to the health plan you choose and the reason you want to change plans.

If you decide to leave your Medicare Advantage plan and switch back to Original Medicare, Part A and Part B, you’re allowed to do so during the annual Medicare Advantage Disenrollment Period, which runs from January 1 to February 14. You can add a stand-alone Medicare Part D prescription drug plan during that period.

Types of Medicare Advantage plans in Indiana

Once you decide to sign up for private health insurance, you may find that you have a number of Medicare Advantage plans available to choose from in Indiana. Here’s a look at the various types of Medicare Advantage plans that may be available in your part of Indiana.

  • Health Maintenance Organization (HMO) plans generally require you to visit doctors, health-care providers, and hospitals included in your plan’s network. You may also have to obtain a referral from your primary doctor to receive coverage for a number of health services.
  • For a more flexible option, you may want to sign up for an HMO Point-of-Service (HMO-POS) plan, which lets you go out-of-network for some health services, but generally at a higher cost.
  • Other popular Medicare Advantage plans in Indiana include Preferred Provider Organization (PPO) plans, which offer even more flexibility, allowing you to choose doctors, health-care providers, and hospitals outside of the plan’s network (usually at a higher cost).
  • A Private Fee-for-Service (PFFS) plan is a type of Medicare Advantage plan that usually reserves the right to decide how much it will pay for your doctor, health-care provider, and hospital visits. A PFFS plan also determines your share of each expense.
  • A Medicare Medical Savings Account (MSA) plan is a Medicare Advantage plan that combines a high deductible with a savings account. You can use the savings account to pay for your health care expenses.
  • Medicare Special Needs Plans (SNPs) limit enrollment to people with certain health needs and offer coverage tailored to suit those specific needs. There are Medicare SNPs for beneficiaries with specific chronic diseases; people living in nursing homes; and those who are eligible for both Medicare and Medicaid.

Most Medicare Part C plans, including most of those listed above, include prescription drug coverage. Such plans are also referred to as Medicare Advantage Prescription Drug plans, so you can get health and prescription drug coverage a single insurance plan.

Even if you sign up for a Medicare Advantage plan in Indiana, be aware that you may have to continue paying your Medicare Part B premium in order to retain your health coverage.

Comparing Medicare Advantage plans available in Indiana

As a Medicare beneficiary in Indiana, you may find it useful to compare all the Medicare Advantage plans available in your area.

The availability and costs of Medicare Advantage plans generally vary depending on the company selling the insurance, and where in Indiana you live. You may find that some Medicare Advantage plans in Indiana offer premiums as low as $0; but keep in mind that you may have to continue paying your Medicare Part B premium, no matter which Medicare Advantage plan you choose.

Some Medicare Advantage plans may offer additional benefits beyond what is included in Original Medicare, Part A and Part B, so you will want to think about what kind of coverage you need or want, plus whether or not you want prescription drug coverage with your Medicare Advantage policy. With all these options available in Indiana, you can see why it may be a good idea to review and compare each plan so you can find one that might offer the benefits and costs suited to your individual needs.

To start comparing Medicare Advantage plans in Indiana today, enter your zip code above for a customized list of plans available in your area. You can also enter your medications to refine your search.

If you need additional information about Medicare in Indiana, view the following resources: