The 2022/2023 Health Insurance Exchange in Indiana provides extremely affordable medical coverage in all areas of the state. Whether you’re a young adult, or nearing Medicare-eligibility, each Metal tier offers several very attractive individual and family policies. If you apply during the Open Enrollment period, your pre-existing conditions are covered, and your rates may dramatically drop if you qualify for a federal subsidy. Many plans offer $0 premiums.

We make it easy for you to find the cheapest Marketplace rates in the Hoosier state for both single and multi-person households, and also subsequently enroll for coverage. Our direct application links reduce the enrollment process time by 50% and expedites the approval of the policy. It only takes about 20 minutes to purchase a policy with or without a federal subsidy. You may also select a non-Obamacare plan that features different carriers, and alternative benefits. If you do not qualify for a federal subsidy, prices may be substantially lower on off-Exchange coverage.

Under-65 plans provide comprehensive benefits, including hospital, office visit, ER, Urgent Care, inpatient and outpatient surgery, and maternity. Additional coverage includes diagnostic testing, imaging (MRIs and CT/PET scans), facility fees, physician and surgeon charges, home health care, skilled nursing care and hospice services. Pediatric dental benefits are considered to be “essential,” but not mandatory. Separate dental and vision plans can also be purchased, although an instant tax credit is not offered. Additional ancillary products can be purchased at any time throughout the year.

Note: Indiana Medigap coverage is available to Seniors that are Medicare-eligible. The Open Enrollment Period runs from October 15th through December 7th for 2022 effective dates. However, a 7-month window is also provided that surrounds the month you reach age 65. Advantage, Supplement, and Part D prescription drug plans are offered from many companies.

MedSup plans are standardized while Advantage contracts often include prescription benefits, and other extra coverage, including dental, vision, and hearing. Plan G (HD) is available for new enrollees that prefer a high-deductible option. Once the deductible is met, 100% coverage is effective for all covered benefits.

Below, we have examined and compared all available plans in the state, so you can view the least expensive options in your area. Of course, depending on your overall health, often a more expensive upgraded contract may be the most cost-effective option in covering your medical expenses. However, if you qualify for a federal subsidy (we’ll calculate the amount for you), a cost-sharing Silver-tier plan often should be strongly considered.

Ambetter, Anthem, US Health And Life, and CareSource are the only carrier options, since MDwise no longer offers private plans to applicants under age 65. Aetna, Humana, UnitedHealthcare, Cigna, and other companies offer Group and/or Senior products. Note: Anthem also provides non-Obamacare temporary plans (Enhanced Choice). These policies are also offered outside of Open Enrollment periods.

Catastrophic Tier  (Federal Subsidies are not available in this Tier. You must also be under age 30)

No available plans.

 

Bronze Tier

CareSource Marketplace Bronze – $8,700 deductible with 0% coinsurance. Zero Cost Telemedicine Partner coverage. Low-cost drugs are subject to $30 copay ($75 mail-order). Other non-preventative drugs are subject to deductible and coinsurance. Urgent Care visits must meet deductible. Children’s dental checkup covered with a $0 copay. Generally, this plan is the least expensive option for most areas of the state.

CareSource Marketplace Bronze, Dental, Vision, And Fitness – Identical to prior plan but with dental, vision, and fitness benefits.

CareSource Marketplace Bronze First – $7,700 deductible with 50% coinsurance. Zero Cost Telemedicine Partner coverage. $40 and $80 office visit copays. Low-cost drugs are subject to $25 copay ($62.50 mail-order). Other non-preventative drugs are subject to deductible and coinsurance. Urgent Care visits must meet deductible and a $100 copay. Children’s dental checkup covered with a $0 copay.

CareSource Marketplace HSA Eligible Bronze – HSA-eligible plan with $5,400 deductible, $7,000 maximum out-of-pocket expenses, and 50% coinsurance. This plan is ideal for healthy households that rarely meet a deductible. Preventative benefits continue to be provided with no out-of-pocket expenses, but all other items must meet deductible. Negotiated discounts also help reduce costs.

Ambetter Essential Care 2 HSA – HSA-eligible plan with $6,900 deductible with 0% coinsurance. This plan is slightly more expensive than the CareSource HSA.

Ambetter Essential Care 2 HSA + Vision + Adult Dental – Identical to prior plan, but with vision, and adult dental benefits included.

Ambetter Essential Care 1 – $8,600 deductible with 0% coinsurance. Preferred generic and generic drug copays are $5 and $25.

Ambetter Essential Care 1 + Vision + Adult Dental – Identical to prior plan, but with vision and adult dental benefits included.

Anthem BCBS Bronze Pathway Essentials 6550 – $6,550 deductible with 40% coinsurance. $75 Urgent Care copay.

US Health And Life Ascension Balanced Bronze 2 – $8,700 deductible with 0% coinsurance. $25 pcp office visit copay. $15 generic drug copay.

US Health And Life Ascension Balanced Bronze 1 – $8,000 deductible with 50% coinsurance. $50 and $100 office visit copays. $20 generic drug copay.

Silver Tier

Ambetter Balanced Care 11 – $6,000 deductible with 40% coinsurance. Office visit copays are $30 and $60. The Urgent Care copay is $60. Generic and preferred brand drug copays are $20 and $55. $30 copay for diagnostic tests.

Ambetter Balanced Care 31 – $5,450 deductible with 10% coinsurance. Office visit copays is $20 (pcp only). The Urgent Care copay is $60.

Ambetter Balanced Care 30 – $6,100 deductible with 0% coinsurance.

Ambetter Balanced Care 32 – $8,100 deductible with 50% coinsurance. Office visit copays are $45 and $100. The Urgent Care copay is $60. Preferred generic drug copay is $5. Generic and preferred brand drug copays are $25 and $75 ($62.50 and $187.50 mail order). $50 copay for lab and professional services.

Ambetter Balanced Care 12 – $6,500 deductible with 40% coinsurance. Office visit copays are $35 and $70. The Urgent Care copay is $55. Preferred generic drug copay is $5. Generic and preferred brand drug copays are $25 and $60 ($62.50 and $150 mail order). $35 copay for lab and professional services.

CareSource Marketplace Low Premium Silver – $6,500 deductible with $8,700 maximum out-of-pocket expenses and 30% coinsurance. $30 and $70 office visit copays with $75 Urgent Care copay.  $20 and $50 copays on low-cost and preferred brand drugs ($50 and $125 90-day mail order copays).

CareSource Marketplace Low Premium Silver Dental, Vision, and Fitness – Similar to previous plan but slightly more expensive with dental, vision, and fitness benefits included.

CareSource Marketplace Standard Silver – $5,800 deductible with $7,900 maximum out-of-pocket expenses and 20% coinsurance. $25 and $60 office visit copays with $75 Urgent Care copay.  $20 and $50 copays on low-cost and preferred brand drugs ($50 and $125 90-day mail order copays).

CareSource Marketplace Standard Silver, Dental, Vision and Fitness – Similar to previous plan but slightly more expensive with dental, vision, and fitness benefits included.

CareSource Marketplace Low Deductible Silver – $5,100 deductible with $7,500 maximum out-of-pocket expenses and 20% coinsurance. $25 and $60 office visit copays with $75 Urgent Care copay.  $20 and $50 copays on low-cost and preferred brand drugs ($50 and $125 90-day mail order copays).

CareSource Marketplace Low Deductible Silver, Dental, Vision and Fitness – Similar to previous plan but slightly more expensive with dental, vision, and fitness benefits included.

US Health And Life Ascension Personalized Care Low Premium Silver – $6,000 deductible with $8,700 maximum out-of-pocket expenses and 40% coinsurance. $40 and $80 office visit copays.  $20 and $50 copays on generic and preferred brand drugs.

Anthem BCBS Silver Pathway Essentials 6550 – $6,550 deductible with $8,700 maximum out-of-pocket expenses and 40% coinsurance. $30 and $75 office visit copays.  $15 and $40 copays on generic and preferred brand drugs. $75 Urgent Care copay.

 

Gold Tier

Ambetter Secure Care 5 – $1,450 deductible with 20% coinsurance. Office visit copays are $15 and $35. The Urgent Care copay is $35. Generic and brand name drug copays are $15 and $30 ($37.50 and $75 mail order). $15 copay for lab outpatient and professional services.

Ambetter Secure Care 20 – $750 deductible with 35% coinsurance. Office visit copays are $35 and $55. The Urgent Care copay is $35. Generic and preferred brand drug copays are $15 and $60 ($37.50 and $150 mail order). $35 copay for lab outpatient and professional services.

US Health And Life Ascension Personalized Care Gold – $3,500 deductible with 20% coinsurance. Office visit copays are $25 and $50. Urgent Care visits are subject to the deductible. The generic drug copay is $15.

Anthem Gold Pathway Essentials 2700 – $2,700 deductible with $5,350 maximum out-of-pocket expenses and 20% coinsurance. $25 pcp office visit copay with $75 Urgent Care copay.  $20 and $40 copays on generic and preferred brand drugs ($60 and $120 90-day mail order copays).

CareSource Marketplace Gold – $2,000 deductible with $6,500 maximum out-of-pocket expenses and 20% coinsurance. $20 and $50 office visit copays with $75 Urgent Care copay.  Covered telemedicine visits have $0 copay. $15 and $50 copays on generic and preferred brand drugs ($37.50 and $125 90-day mail order copays).

CareSource Marketplace Gold Dental, Vision, and Fitness – Similar to previous plan but slightly more expensive with dental, vision, and fitness benefits included.

Platinum Tier

No available plans

After Open Enrollment Ends

You can apply for coverage after the end of each Open Enrollment period. However, to qualify for a Marketplace plan, you need a “Special Enrollment Period” exception (SEP). Situations that qualify for this exemption include losing coverage from a divorce, moving to a different service area, termination of an employer-sponsored plan, exhaustion of COBRA benefits, reaching age 26, becoming pregnant, or change in citizenship or immigration status. However, you must convert to a new plan within 60 days or wait until the next OE period. The SEP exception does not guarantee that you will receive a federal subsidy. You may also choose a non-compliant plan without paying a penalty. Last year, a special COVID OE period was offered between February 15 and May 15.

If you go beyond the 60-day period, although several options are offered, coverage for pre-existing conditions is not guaranteed, and “essential benefits” may not be fully included in the policy you select. Alternative plans often feature lower premiums and quick underwriting approval. However, benefits, including prescription drug coverage, may be limited, and higher out-of-pocket expenses may be applied to major medical claims. If a spouse becomes eligible for new coverage, you also may be able to be added to the policy without medical underwriting. For example, a new job may offer immediate benefits for all family members. Leaving incarceration or becoming a US citizen may also qualify for an SEP.

If you voluntarily terminate or cancel a plan, let your policy lapse, or simply forget to enroll for coverage, an exemption will not be granted. However, you can apply for temporary benefits that can potentially cover large medical expenses until you are eligible for the following Open Enrollment. But during this period, larger potential out-of-pocket expense situations are more likely. Several short-terms can be kept for 12 months (four consecutive three-month plans). Temporary policies typically don’t contain all of the benefits provided by Exchange contracts, including maternity coverage.

If you don’t qualify for an SEP exemption, additional options are available. Simply contact us and we can review the most affordable individual and family health insurance plans in Indiana. Some of these options include non-compliant plans that do not satisfy Obamacare legislation mandates. Previously, although the prices of these policies were quite low, you had to pay up to 2.5% of your household income as a special tax. This penalty, however, expired two years ago. Plans ad prices can differ from one county to another.

 

Under Age-65 Monthly Rates

Shown below are prices for the three least expensive plans in Indiana’s largest Counties. Rates are based on a married couple (ages 45) with household income of $50,000.

Marion County

$29 – CareSource Marketplace Bronze

$33 – Ascension Personalized Care Balanced Bronze 2

$51 – Ascension Personalized Care Balanced Bronze 1

$68 – CareSource Marketplace Bronze First

$97 – Anthem Bronze Pathway Essentials 6550

 

Lake County

$47 – CareSource Marketplace Bronze

$82 – CareSource Marketplace Bronze First

$198 – CareSource Marketplace HSA Eligible Bronze

$204 – Ambetter Essential Care 1

$227 – CareSource Marketplace Low Premium Silver

 

Allen County

$43 – CareSource Marketplace Bronze

$83 – CareSource Marketplace Bronze First

$141 – Ambetter Essential Care 1

$202 – Ambetter Essential Care 1

$216 – CareSource Marketplace HSA Eligible Bronze

 

Hamilton County

$29 – CareSource Marketplace Bronze

$33 – Ascension Personalized Care Balanced Bronze 2

$51 – Ascension Personalized Care Balanced Bronze 1

$68 – CareSource Marketplace Bronze First

$97 – Anthem Bronze Pathway Essentials 6550

 

St. Joseph County

$37 – CareSource Marketplace Bronze

$74 – CareSource Marketplace Bronze First

$197 – CareSource Marketplace HSA Eligible Bronze

$207 – Ambetter Essential Care 1

$228 – CareSource Marketplace Low Premium Silver

 

Elkhart County

$37 – CareSource Marketplace Bronze

$74 – CareSource Marketplace Bronze First

$197 – CareSource Marketplace HSA Eligible Bronze

$207 – Ambetter Essential Care 1

$228 – CareSource Marketplace Low Premium Silver

 

Vanderburgh County

$40 – CareSource Marketplace Bronze

$76 – CareSource Marketplace Bronze First

$92 – Ascension Personalized Care Balanced Bronze 2

$109 – Ascension Personalized Care Balanced Bronze 1

$161 – Ambetter Essential Care 1

$198 – CareSource Marketplace HSA Eligible Bronze

 

Tippecanoe County

$46 – CareSource Marketplace Bronze

$71 – Anthem Bronze Pathway Essentials 6550

$82 – CareSource Marketplace Bronze First

$96 – Anthem Bronze Pathway Essentials 5500

$199 – CareSource Marketplace HSA Eligible Bronze

$215 – Anthem Silver Pathway Essentials 6550

 

Porter County

$47 – CareSource Marketplace Bronze

$82 – CareSource Marketplace Bronze First

$198 – CareSource Marketplace HSA Eligible Bronze

$204 – Ambetter Essential Care 1

$227 – CareSource Marketplace Low Premium Silver

$263 – Ambetter Essential Care 5

 

Hendricks County

$29 – CareSource Marketplace Bronze

$33 – Ascension Personalized Care Balanced Bronze 2

$51 – Ascension Personalized Care Balanced Bronze 1

$68 – CareSource Marketplace Bronze First

$97 – Anthem Bronze Pathway Essentials 6550

$125 – Anthem Bronze Pathway Essentials 5500

$144 – Ascension Personalized Care No Deductible Bronze

 

Johnson County

$47 – CareSource Marketplace Bronze

$61 – Ascension Personalized Care Balanced Bronze 2

$72 – Anthem Bronze Pathway Essentials 6550

$78 – Ascension Personalized Care Balanced Bronze 1

$85 – CareSource Marketplace Bronze First

$99 – Anthem Bronze Pathway Essentials 5500

$159 – Ambetter Essential Care 1

 

Monroe County

$32 – CareSource Marketplace Bronze

$57 – Anthem Bronze Pathway Essentials 6550

$70 – CareSource Marketplace Bronze First

$84 – Anthem Bronze Pathway Essentials 5500

$144 – Ambetter Essential Care 1

$196 – CareSource Marketplace HSA Eligible Bronze

 

 

Indiana Medicare Open Enrollment For Seniors

Open Enrollment begins on October 15th and ends on December 7th. However, if you have reached age 65 or are eligible for Medicare, you do not participate or purchase plans through the Marketplace. During these dates, you can change your existing plan and/or your prescription drug coverage. The effective date of the changes would be on January 1st. If you miss the deadline, it’s possible that you may be able to enroll in a plan, although medical underwriting may be required.

If you are currently enrolled in a Medicare Advantage plan, you can change to original Medicare. Your Part D benefits (drugs/prescriptions) can be purchased separately. Medigap (Supplement) coverage may also be offered, depending on your zip code or county. These plans are issued and underwritten by private insurers (Humana, Blue Cross, Aetna, UnitedHealthcare, Cigna, for example). Rates will vary, depending upon your age, gender, and county of residence. Often, dental and vision benefits are included, along with several additional perks, including gym memberships and hearing coverage.

There are many more carriers offering products to Seniors instead of persons under age 65. However, plans are standardized and easier to compare benefits. The Centers of Medicare and Medicaid Services, which is controlled by Congress, operate the federal program. If you are eligible for Social Security, you can request benefits. Listed below are several of the larger companies that offer Indiana Medicare Supplement coverage: (Issue Age And Attained Age Policies)

AARP-UnitedHealthcare

Accendo

Aetna

Anthem

Assured Life

Bankers Fidelity

Capitol Life

Central States

Cigna

Colonial Penn

Everence

Globe Life

GPM Health

Great Southern Life

Guarantee Trust Life

Humana

Independence American

Lumico Life

Manhattan Life

National Health

New Era Life

Oxford Life

Pan-American Life

Philadelphia American Life

Physicians Life

Resource Life

State Farm

Transamerica

Union Security

United American

United World Life (Mutual Of Omaha)

USAA

PAST UPDATES:

Indiana’s Children’s Health Insurance Program (CHIP) received great news. The federal government will pay more than 99% of the plan costs for the next two years. Originally, the reimbursement was going to be approximately 77%. This should help enrollment, which is typically among the lowest (percentage of state population) in the US. The extra revenue is expected to be about $25 million.

Only seven states receive more than 98% reimbursement of CHIP costs. The program is designed for households that make too much money to qualify for Medicaid, but also can not afford private medical plans offered by carriers in their area. More than 8% of children in the state are without coverage.

Anthem continues to lead all carriers in market share and this year will not be an exception. However, if you’re looking ahead, anticipated changes by President Trump should increase the number of available companies. Perhaps, Cigna, Aetna, and UnitedHealthcare will return.

Open Enrollment has been shortened. The first day is November 1 and the last day is December 15th. Anthem, Aetna, and UnitedHealthcare did not offer private plans last year.