Curious about health care options in the Hoosier State? According to a study by US News, Indiana has the 40th best health care in the nation. That's thanks to accessibility, quality care, and good public health.
Health insurance options in Indiana
According to the IN Office of the Insurance Commissioner, there are several ways for state residents to get health care:
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Indiana residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 54% | ||
| Individual or family | 5% | ||
| Medicaid | 18% | ||
| Medicare | 15% | ||
| Military | 1% | ||
| Uninsured | 8% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
Eight percent of Indiana residents are uninsured, a few percent below the national average. That's good news for policyholders. More uninsured people leads to higher rates for insured people.
Indiana health insurance companies
What are your health insurance provider options in Indiana? These are some of the state's top insurance providers that offer individual and family plans:
- CareSource
- Celtic
- Anthem
Check insurance company websites to find out how plan options vary based on where in the state you live.
Indiana health insurance costs and rate factors
Hoosiers spend an average of $8,300 per year on health care expenditures, a few hundred more than the national average. So, what determines the price of health insurance for state residents? These are the factors that providers consider while pricing your policy:
Plan type
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. You'll pay more in monthly premiums for a higher level of coverage.
These are the average monthly premiums for each plan type for a 40-year-old IN resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $310 | $381 | $534 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Increasing your coverage from a bronze plan to a gold plan costs about 72 percent more. The cost jumps because a gold plan covers 80 percent of health care costs, whereas a bronze plan covers 60 percent of costs.
The lowest level of coverage is a catastrophic plan. These types of plans have low monthly premiums but a high deductible of $8,150. This means that a bronze or silver plan may save you money if you need to use your health insurance. Catastrophic plans are only available to people under 30 or with certain exemptions.
Body mass index
According to the CDC, a high body mass can lead to several health conditions. That's why insurance providers look at your BMI to determine your risk-level. A higher BMI leads to higher premiums.
In 2018, Indiana had a 34 percent obesity rate, the 15th highest rate in the country. Out of the IN residents who used QuoteWizard to compare health insurance plans, 35 percent have a BMI in the obese range.
Tobacco use
Insurers know that there are substantial risks from smoking. Smokers pay more for health insurance because of those risks. About 21.1 percent of Indiana residents are smokers, the 10th highest rate in the country.
Age
According to HealthCare.gov, older people pay up to three times more for health premiums than younger people do. IN residents who use QuoteWizard to shop for health insurance are, on average, 41 years old.
Location
Location plays an important role in how much you pay for coverage. Each state has different laws, regulations, and providers surrounding their health care marketplace.
Health insurance plans are often community-rated. This means that your rates depend on how many claims the people around you file. So, if a neighbor files an abnormally high number of claims, your monthly prices could spike.
Because of these factors, living in a health-conscious state could save you money. According to America's Health Rankings, Indiana is the 38th healthiest state in the country.
Indiana health insurance laws
The Affordable Care Act mandates what insurance providers cannot consider while pricing your policy.
- Pre-existing conditions: The ACA does not allow insurers to charge more to people with pre-existing conditions. This used to limit access for those with health problems because companies would deny them or charge them more.
- Gender: According to Health Services Research, women have historically paid more for health insurance. However, the ACA doesn't allow insurers to charge women and men a different price for the same plan.
- Insurance and medical history: People with lapses in insurance coverage or previous medical conditions used to be charged more for coverage. The ACA doesn't allow that to happen anymore.
There are limits to how much you can pay out-of-pocket for a marketplace plan. For 2020, the out-of-pocket marketplace plan limit is $8,150 for an individual plan and $16,300 for a family plan.
IN health insurance companies are required to offer at least some coverage for these services:
- Maternity benefits
- Newborn testing
- Diabetes treatment
- Clinical trials
- Substance abuse treatment
- Cancer screenings
- Coverage for prosthetic devices
This type of coverage can vary, so check cms.gov for the entire list.
Medicare and Medicaid in Indiana
Medicare and Medicaid are government-funded health care programs that aid different groups of people. Medicare offers coverage for seniors, and Medicaid helps low-income families and children.
Medicare
Medicare is available to residents 65 years and older. The program has several plan options, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for one of Indiana's Medicare Savings Programs with these income limits:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
The number of uninsured Americans has improved a great deal since the Affordable Care Act (ACA) became law in 2010. Medicaid expansion was influential in reducing Indiana’s overall number of uninsured residents.
In 2008, 13.8% of Indiana's residents did not have medical insurance. After the state expanded its Medicaid program, their uninsured rate dropped to 8.8% between 2014 and 2019. The main drive of this was a 37% increase — or 1,152,900 Indiana residents — in Medicaid enrollment from 2008 to 2019.
Medicaid in Indiana is primarily meant for low-income families and children. These are the state's Medicaid financial requirements:
| Household Size | Maximum Monthly Income |
|---|---|
| 1 | $1,485 |
| 2 | $2,006 |
| 3 | $2,528 |
| 4 | $3,049 |
| 5 | $3,571 |
Indiana Department of Insurance
- Website:
- Homepage
- Insurance Commissioner:
- Stephen W. Robertson
- Insurance Hotline:
- (800) 622 - 4461
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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