Saving money on your Indiana Healthcare expenses is possible! Lowering copays, deductibles, and coinsurance will reduce your out-of-pocket expenses each year. But most importantly, you can still find quality health insurance plans (on and off the Exchange) from top companies such as Anthem Blue Cross and Blue Shield, MDwise, Ambetter, and CareSource. Additional companies offer employer-provided group coverage and Senior Medigap plans.
Regardless if you live in Indianapolis, Fort Wayne, Terre Haute, or Richmond, or you’re 25 and single or 45, and married with children, we help you lower your premium. Our website is packed with money-saving tips and current information. We compare all available options (on and off the Marketplace) and present you with the most affordable choices. If you are currently under treatment for an existing condition, we will find the plans that best cover your medications, hospital bills, office visits (pcp and specialist) and any future treatment.
We also provide personalized assistance after you have purchased coverage, since that’s when many questions are asked. During and after Open Enrollment, there are many low-cost options, and you may be eligible for a subsidy from the federal government or a Special Enrollment Period (SEP) exception. We calculate the amount you can receive, and explain which policies best meet your unique situation.
That’s right. You won’t know how much you can save unless you know what other carriers will charge you. There might be very little difference or you may save thousands of dollars each year. We make it easy for you to compare the best healthcare in Indiana. And with more than three decades of experience, we’re confident the quotes you view, will be the least expensive options offered by the most reputable companies. It’s actually the law! You can also choose to select more expensive plans that offer smaller deductibles and copays, and better non-generic prescription drug benefits.
By doing the shopping for you, we save you hours of time and frustration, since we can quickly show you the best deals for you or your family. Whether you need benefits for a month, a year or much longer, we customize a plan so it fits perfectly within your budget. If you are being treated for a chronic illness, we focus on policies that result in the lowest possible out-of-pocket expenses. If you qualify for Medicaid, you will be shown which government programs are available.
Take Advantage Of Federal Subsidies
Past changes in national legislation award federal subsidies that will directly lower the cost of your health insurance in Indiana. To qualify, your individual (or household, if more than one person) income must be below 400% of the Federal Poverty Level. Income below 138% may qualify for Medicaid, which will pay almost all of your premium. The eligibility guide may help you determine if you can qualify for assistance.
Since the reimbursement is on a sliding scale, the less money you make, the bigger the subsidy you will receive. The amount of financial assistance you receive is based on your projected income for the following year. So, if you underestimate…yes, you will have to pay some of it back! NOTE: The new Healthy Indiana plan (HIP 2.0) expanded Medicaid benefits and created a “POWER” (Personal Wellness And Responsibility) account.
Only Pay For What You Need
Of course, it’s impossible to accurately predict what your medical expenditures are going to be in a given year. However, they will probably closely approximate the expenses from immediate prior years. Thus, if you have averaged about two or three annual non-preventive office visit in the last five years, there’s a good chance that that pattern will continue. And if your health is good, you can change plans at any time.
This should not be the sole criteria you use when making your choices. There also may be mandatory required benefits that you are not using or are likely to use, such as maternity, non-generic generic prescription coverage with high copays or dental and vision benefits that may not be needed. For example, in these situations, considering a Silver or Bronze-tier plan may be more applicable than a more expensive Gold or Platinum-tier option.
However, if conditions change (either medical or financial), a new Open enrollment begins each year. Your federal subsidy eligibility may change if your household income significantly changed. We may also recommend a different carrier and plan, especially if your existing carrier substantially increased your premium. There is also the possibility that carriers will leave and enter the state, creating new and lost opportunities. For example, although Cigna, Aetna, and UnitedHealthcare only offer Senior or Group products, by 2019, they offer individual medical plans again.
Open Enrollment Impact
Don’t cancel or change coverage without first consulting an experienced broker. It’s possible that you may not be able to reinstate your prior policy until the next Open Enrollment. Unless you qualify for a special exemption, you may have to keep the policy you have until the end of the calendar year. Since there are very few exceptions, it’s important to properly review and compare all policy options before making your selection.
Of course, with annual Open-Enrollments now mandatory, that does provide more flexibility. Thus, if you are enrolled in an expensive “Platinum” plan, you can change to the cheap “Bronze” plans at the end of every year. And of course, if major medical expenses are looming, you will be able to change to a much more comprehensive contract with fewer expenses you must pay. However, regardless if you retain or change plans, a new deductible period begins on January 1. Therefore, if a major surgery is planned in December, postpone to January, unless the delay jeopardizes your health.
Consider an HSA
Indiana has very affordable Health Savings Account rates. They will also allow you to set up your own savings account and can recommend the banks they have working relationships with. In the upcoming years, it is possible that additional carriers will offer Marketplace options. NOTE: UnitedHealthcare offers employer-sponsored coverage, but not private medical plans. Aetna and Humana also offer medical plans in the state, but not private comprehensive coverage for persons under age 65.
With an HSA, you have much greater control over how your health care dollars are spent and who gets them. Usually, there is “Network” coverage which allows the insured to choose a doctor, specialist or other medical facility for treatment. One of the best features is that your insurer negotiates for you, often reducing your costs by as much as 50%-70% on certain items. Lab fees, MRIs and diagnostic tests often receive the biggest discount. However, inpatient and outpatient hospital visits will also benefit from repricing.
Although a “High Deductible” plan is required to accompany the HSA, the reduction in premiums offers the opportunity to deposit significant amounts of money in an account that pays for qualified expenses with tax-deferred dollars. You can freely take money out of the account since you retain complete control. When you reach age 65 and Medicaid-eligibility, your funds will still be available. If you use the funds for non-deductible items, there will be adverse tax consequences.
The most affordable Indiana HSA Plans are listed below:
Anthem Bronze Pathway X 20 for HSA – $5,200 deductible with 20% coinsurance and maximum out-of-pocket expenses of $6,300.
Anthem Bronze Pathway X 0 for HSA – $6,550 deductible with 0% coinsurance.
Anthem Silver Pathway X 0 for HSA – $3,000 deductible with 10% coinsurance.
The following plans are no longer available.
IU Health Plans Bronze Simple HSA – $6,500 deductible with 0% coinsurance. Not available in all areas.
IU Health Plans Bronze HSA – Similar to previous plan, but with $4,500 deductible and $6,200 maximum out-of-pocket expenses. Typically about 4% more expensive than “Simple” option.
UnitedHealthcare Bronze Choice HSA 5500 EPO – $5,500 deductible with $6,500 maximum out-of-pocket expenses.
Anthem Silver Pathway X 10 for HSA HMO – $3,000 deductible with 10% coinsurance and maximum out-of-pocket expenses of $4,000.
UnitedHealthcare Silver Choice HSA 3000 EPO – $3,000 deductible with $6,500 maximum out-of-pocket expenses.
Is It Preventive?
Under all qualified catastrophic AND comprehensive medical plans in Indiana, recognized preventive expenses are paid in full by the health insurance company. There is no copay or coinsurance to pay, no deductible to meet, and a waiting period does not apply. Both pediatric and adult routine annual physicals are covered at 100%. Diagnostic testing and screening is generally considered “preventive” if completed at the time of the annual physical.
NOTE: If during a preventative visit, a medical issue is discovered, although covered, the cost of that specific treatment may be subject to applicable copays and deductibles. This often occurs with mammograms and a colonoscopy. For example, if cancerous (or non-cancerous) polyps are discovered and removed, the cost of treatment will not be covered under the preventative clause.
Some of the most common approved services and covered conditions (other than annual physicals and OBGYN visits) listed under the ACA legislation include use of aspirin (some ages), cholesterol screening, depression, diabetes screening, immunizations, STI prevention and counseling. Specific benefits for women include breast cancer mammography and chemo-prevention, folic acid supplements, breastfeeding support and counseling, and cervical cancer screening.
Since these lists tend to get updated every year, we’ll keep you current on any changes. Some of the more recent additions include diet counseling, Osteoporosis screening, contraception and obesity screening and counseling.
Reducing medical expenses is much easier when you are physically fit. Perhaps the word hasn’t reached Indianapolis yet since this month, Central Indiana was ranked the worst largest metropolitan area in terms of resident’s fitness and health. That’s quite a dubious distinction.
The American College of Sports Medicine released their study last month and noted how high smoking and obesity rates are in the area. The lack of exercise, bad eating habits, and incidence of heart problems and diabetes are major factors.
Although regional businesses are attempting to change this disturbing trend, until positive results are achieved, healthcare rates will continue to be higher than other similar areas.
Lowering healthcare expenses remains a challenge, especially as Indiana health insurance rates continue to increase, and the number of available companies offering Marketplace coverage, decreases. However, as 2017 Open Enrollment approaches, we will continue to review all policy options, and inform you which plans are the most economical.
With no major legislative changes planned, it appears that 2018 rates may be higher again, with fewer available carriers in most states. Within the next four months, insurers will determine which states they will offer coverage.