Family health insurance coverage in Indiana is surprisingly affordable since the price of covering everyone on a single policy is often less than purchasing separate policies. We understand that small copays, low rates and comprehensive preventive benefits are extremely important when comparing options. The establishment of the Exchange (also referred to as the “Marketplace”) provides many low-cost options with the help of the Obamacare federal subsidy.
For more than 38 years, we have helped Indiana residents apply, shop and purchase the best medical plans offered by all of the top-rated companies. We realize that comparing multiple companies, calculating a subsidy, understanding Open Enrollment rules, and applying for coverage can be very confusing and stressful. The average cost of family coverage, as you might expect, is largely dependent on the number of persons in your household, and the total reported income.
We help you find the plans that cost the least, but still gives you the best benefits. Rates are always the lowest available prices and you can quickly compare options and apply for coverage any time of the day. We specialize in finding comprehensive office visit and prescription drug coverage for all family members. High-deductible and HSA options are also offered for households that rarely submit major medical claims.
Private Plans Often Less Expensive Than Group Plans
Your savings could be significant considering the average cost of an employer family plan is now more than $17,000! Group premiums have been rising, especially since many small and mid-sized employers have reduced their contributions. Often, spouses and dependent rates are not subsidized, and rates are very expensive. Fewer choices are now being offered compared to 10 years ago. Instead of three or four major carriers offering options (UnitedHealthcare, Humana, Aetna, Kaiser, Blue Cross, etc…), most employers utilize one or two carriers. IU Health Plans is not currently;y offering private under-65 plans.
Health Savings Account information can be found on this page. If all household members have no major medical conditions, and do not regularly take expensive medications, and are not being treated for chronic illnesses, an HSA should strongly be considered. Although a deductible applies to all non-preventative expenses, network-negotiated discounts and tax-deductible contributions help make HSAs a very cost-effective option. Group HSAs are common, with the employer occasionally depositing up to $3,000 in your account.
Best Available Policies
Throughout Open Enrollment (November 1st through December 15th), no medical questions are asked, pre-existing conditions are covered and an instant and immediate federal tax subsidy reduces your premium. “Special Enrollment Periods” allow you to apply for coverage at any time throughout the year.
These “special” periods allow individuals and families to enroll in 2018 Marketplace plans and utilize the federal subsidy. Some of the most popular scenarios that let you apply for a policy are if you move, get divorced, have a child, lose coverage through work, or have a major change in income. Of course at any time, you can purchase the cheapest form of coverage, which is a short-term plan.
But assuming you have dependents, including children, you need affordable policies that offer “family-friendly” features, such as low copays on primary care physician (pcp) and specialist visits, free preventive care, maternity and prenatal coverage. Lower deductibles help if any household member is hospitalized or needs an expensive outpatient procedure.
We have listed below some of the plans that meet those guidelines and are eligible for large subsidies to reduce the premium:
Gold Tier
CareSource Gold – $10 copay for pcp visits and $50 copay for specialist office visits. Urgent Care visits are subject to a $75 copay. Generic and preferred brand drug copays are $10 and $50 ($25 and $125 for mail-order). The policy deductible is $1,500.
Ambetter Secure Care 1 – First three pcp office visits are covered at 100%. Urgent Care visits are subject to a $75 copay. Generic and preferred brand drug copays are $10 and $25 ($30 and $75 for mail-order). The policy deductible is $1,000.
CareSource Hoosier Gold – $10 copay for pcp visits and $50 copay for specialist office visits. Urgent Care visits are subject to a $75 copay. Generic and preferred brand drug copays are $10 and $50 ($25 and $125 for mail-order). The policy deductible is $1,500.
Silver Tier
Ambetter Balanced Care 5 – $40 copay for pcp visits and $80 copay for specialist office visits. Urgent Care visits are subject to a $100 copay. Generic and preferred brand drug copays are $20 and $60 ($60 and $180 for mail-order). The policy deductible is $7,350.
CareSource Low Premium Silver – $20 copay for pcp visits and $40 copay for specialist office visits. Urgent Care visits are subject to a $100 copay. Generic and preferred brand drug copays are $20 and $50 ($50 and $125 for mail-order). The policy deductible is $6,150.
Ambetter Balanced Care 4 – $30 copay for pcp visits and $60 copay for specialist office visits. Urgent Care visits are subject to a $100 copay. Generic and preferred brand drug copays are $15 and $50 ($45 and $150 for mail-order). The policy deductible is $7,050.
Ambetter Balanced Care 2 – $30 copay for pcp visits and $60 copay for specialist office visits. Urgent Care visits are subject to a $100 copay. Generic and preferred brand drug copays are $15 and $50 ($45 and $150 for mail-order). The policy deductible is $6,500.
Also, there are several non-profit entities that can offer some basic informational assistance such as the Robert Wood Johnson foundation, who provides updates on the progress of healthcare reform in all US sates. The CHIP program (Indiana Children’s Health Insurance) helps children obtain low cost coverage. The Federal Balanced Budget Act (1997) was responsible for this program that has helped thousands of kids in the US.
Comprehensive Policies
The most common type of family coverage is a “comprehensive” plan. Typically, comprehensive policies include benefits for office visits (including specialists), prescriptions, preventive coverage, inpatient and outpatient expenses, major medical protection and emergency room charges. Most policies provide the office visit, prescription and preventive coverage without having to meet a large deductible, or simply none at all.
Naturally, higher deductibles will reduce the premium. Of course, a larger deductible means higher possible out of pocket expenses. However, you will see savings every year while the higher out of pocket costs might only be seen every 3-5 years (or possibly longer). And many grandfathered policies still offer “vanishing deductibles” that simply reduce the deductible each year you don’t meet it. Potentially, it can save thousands of dollars. If you start with a $5,000 amount, it can reduce to half of that amount. It’s a great inducement to stay healthy and out of the ER or hospital!
Free Preventative Benefits
All non-temporary policies allow you to use your preventive benefit without meeting a deductible or copay, and you do not have to wait for the coverage to be effective. For example, once the policy is approved and in-force, you may schedule a routine annual physical for yourself or any family member. Naturally, it’s still best to check with the insurer to verify coverage and to make certain your physician is “in Network.” Many tests and immunizations are also covered with no out-of-pocket expenses.
All Metal policies (Platinum, Gold, Silver and Bronze) provide many additional preventive services that will require no out-of-pocket costs. Many of these items are “screenings” that are designed to predict and treat potential problems. Some of the most common screenings include: alcohol addiction, blood pressure, cholesterol, colon and rectal cancer, depression, diabetes, HIV, obesity and nicotine use. Additional toddler and young adult screenings are also offered. And of course, OBGYN visits, and annual routine physicals incur no cost or out-of-pocket expense.
Provider Networks
Most of the companies have very large provider networks. Sometimes, it’s the smaller carriers that force you to drive long distances for treatment. When Exchanges became active in 2014, the number of available physicians and hospitals decreased, since the reimbursement and negotiated discounts were not widely accepted.
Although benefits are much broader now than they were prior to 2014, it’s important to ensure that your existing doctors remain “in-network.” Otherwise, you may face much larger out-of-pocket expenses that could involve hundreds (or thousands) of dollars.
The most effective way to determine if your physician or specialist participates, is to contact their office directly. Although online resources are available, often they are not recently updated.
Indiana HSA Plans
As previously mentioned, we also recommend considering a Health Savings Account (HSA) for your family health care needs. An Indiana HSA will reduce your premiums and allow you to pay for your qualified medical expenses with pre-tax dollars. Preventive benefits are provided without having to meet a deductible and Network-negotiated discounts will reduce your out-of-pocket outlay. Maternity coverage is included, and your out-of-pocket costs should be very close to the deductible on 0% coinsurance plans.
If your top priority is providing catastrophic coverage for large claims, an HSA could potentially save you thousands of dollars in premiums during your lifetime. Anthem, UnitedHealthcare and Humana often have the best options for high-deductible plans for employer group coverage. Cigna stopped offering plans in the state, although their Senior products are very popular.
View Prices Now
You’re able to see current rates by providing some basic information in the quote box at the top of the page. We don’t ask for your social security number or any other financial information. And the family and individual quotes are free without any cost or obligation. Our expertise and experience will ensure that you are always recommended the most affordable high-quality plans.