TABLE OF CONTENTS
When you become eligible for Medicare – at age 65 for most people unless you have a qualifying disability or illness – you can choose to get Medicare coverage one of two ways: through Original Medicare or through a Medicare Advantage Plan. Original Medicare is the default option for most people. It includes Medicare Part A, which most people can get premium-free, and Medicare Part B, which you’ll need to pay for.
Medicare Advantage Plans are an alternative to Original Medicare. These bundled plans provide the same coverage as Original Medicare, but are provided by private insurance companies that have been approved by Medicare. Each Medicare Advantage Plan provider must offer at least the same coverage as Medicare Parts A and B, but many plans choose to provide much more, such as prescription drug coverage. Some may even offer benefits that Original Medicare does not include, such as vision, dental and hearing coverage.
Since each Medicare Advantage Plan is unique, it’s important to compare your options before choosing a plan. This article will go over everything you need to know about Medicare Advantage Plans in Indiana.
Compare ratings of insurance companies offering Medicare Advantage Plans in Indiana:
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||NCQA rating||J.D. Power ranking|
|Aetna||4 stars||Not rated||A+||3 to 4 stars||Fifth out of 6|
|Anthem Blue Cross Blue Shield||4 to 4.5 stars||Not rated||A+||3 to 4 stars||Second out of 6|
|Humana||4.5 stars||A-||A+||3.5 stars||Not ranked|
|UnitedHealthcare||3.5 stars||Not rated||A||3 stars||Sixth out of 6|
You have choices in Medicare coverage. While you can opt to stick with Original Medicare, a Medicare Advantage Plan – also known as Part C – may be a better alternative for you.
|Original Medicare||Medicare Advantage Plans|
|Original Medicare covers your Part A hospital insurance and Part B medical insurance.||Medicare Advantage Plans combine Part A, Part B, and additional benefits.|
|You can add Part D prescription drug coverage.||Prescription drug coverage is usually included.|
|You’re able to use any medical provider in the U.S. that accepts Medicare.||You’ll usually need to use doctors in your plan’s network.|
|You can buy supplemental coverage to manage out-of-pocket costs, including your coinsurance.||Your Medicare Advantage Plan may have lower out-of-pocket costs than Original Medicare.|
|Vision, hearing, dental, and other benefits aren’t covered.||Your plan may offer additional benefits, including vision, hearing, and dental.|
Medicare Advantage Plans cover benefits from Original Medicare Part A (hospital insurance), Part B (medical insurance), usually Part D (prescription drug coverage), and sometimes additional benefits that Original Medicare doesn’t cover. Each Medicare Advantage Plan insurer sets the rules about how you receive and pay for these benefits.
|Hospital and skilled nursing facility inpatient care||Home health care||Prescription drug coverage (if included in your plan)|
|Medically necessary outpatient services, such as:
||Preventive services, such as:
||Additional benefits (depending on your plan), such as:
With 133 Medicare Advantage Plans available in Indiana, you likely have several options in your area. To help you choose the best plan for you, consider what is most important to you before selecting a plan. There are several factors to keep in mind:
There are 133 total Medicare Advantage Plans offered throughout Indiana as of 2022. These plans include:
|Number of Medicare Advantage Plans available||Medicare Advantage Plan types available||Medicare Advantage Plans rated 3.5 or higher by NCQA|
In Indiana, the most common Medicare Advantage plans available are HMOs or PPOs, although there are also a few SNPs and regional PFFS plans available. Seniors eligible for Medicare may choose from plans provided by multiple private insurers, although the choices available vary by county.
HMOs typically require that you receive all services from in network providers:
PPOs include a preferred network of providers, but you have the option of choosing doctors or hospitals from outside of the network for a higher cost.
PFFS plans don’t require a primary care physician or referrals for specialists:
SNPs are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
You’re eligible for Medicare when you turn 65 or if you’re younger and have a qualifying disability. A qualifying disability means at least one of the following applies:
When you become eligible for Medicare, you are also eligible for Medicare Advantage Plans. There are specific times of the year when you can enroll for the first time in a Medicare Advantage Plan: during your Initial Enrollment Period and the Open Enrollment Period.
Medicare Advantage Open Enrollment occurs between January 1 and March 31 of each year. This period is only for beneficiaries already in a Medicare Advantage Plan, and you can change plans or switch to Original Medicare. You cannot switch from Original Medicare to Medicare Advantage during Medicare Advantage Open Enrollment.
There are exceptions to these enrollment periods called Special Enrollment Periods. Certain events or circumstances may make you eligible to change your Medicare Advantage Plan outside of the open enrollment periods, such as if you move outside of your existing plan’s service area or to a location with new plan options you didn’t have before. If you think you may qualify for a Special Enrollment Period, call 1-800-MEDICARE and explain your situation.
|Enrollment period||When it happens||Medicare plans you can choose||What you can do|
|Initial Enrollment Period||Three months before you turn 65, the month you turn 65, and three months after||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Sign up for Medicare Part A and Part B. Complete your Part B enrollment to avoid a late enrollment penalty.|
|General Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan. If you enroll in Medicare during this period, your MAP enrollment is April through June.||Sign up for Medicare if you missed your IEP|
|Open Enrollment Period||October 15 – December 7||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Join, switch, or drop a plan|
|Medicare Advantage Open Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||If you’re enrolled in a Medicare Advantage Plan, you can change your plan or switch to Original Medicare|
|Special Enrollment Period||When you have a qualifying event||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Make changes to your plan|
Most Medicare Advantage HMO and PPO plans and all SNP plans provide prescription drug coverage like you would get from Medicare Part D. Some PFFS plans may provide prescription drug coverage, but not all do. Evaluate a plan’s prescription drug coverage when deciding which Indiana Medicare Advantage Plan to use.
Prescription drug coverage may vary by cost, coverage, and convenience among Medicare Advantage Plans. Your monthly premium may include a premium for the drug coverage in the plan. There is usually a copayment or coinsurance amount that you have to pay for each prescription after you reach your annual deductible.
Some plans use different cost tiers with different costs for different drugs. For instance, you may pay less for generic drugs than brand-name drugs or less for brand-name drugs within different tiers. If your plan uses tiers, the formulary will list all covered drugs and their tiers. Verify your preferred or local pharmacies are included in the plan’s network.
|Resource||Contact||How they help|
|Indiana Commission on Aging||Phone: 888-673-0002||The Division of Aging is committed to helping Hoosiers find the information and resources they need so they can make better decisions, not only for themselves but also for their loved ones|
|Indiana Department of Insurance||Phone: 800-457-8283||The State Information Center (SIC) exists to provide a single point of entry into state government. SIC agents direct customers to the area or agency that provides the needed information, putting down the guesswork and providing the public with easier access to state government agencies|
|Indiana Medicaid||Phone: 800-457-4584||On this site, you can learn about the different Medicaid programs and how to apply|
|IndianaMedicare and SHIP||Phone: 800-452-4800||The State Health Insurance Assistance Program (SHIP) is a free and impartial counseling program for people with Medicare|
|Resource||Contact||How they help|
|Aging and In-Home Services of Northeast Indiana, Inc.||Phone: 260-745-1200||Aging and In-Home Services of Northeast Indiana, Inc. (AIHS) is a private, not-for-profit social service organization serving older adults, persons with disabilities, and their caregivers|
|Area 10 Agency on Aging||Phone: 812-876-3383||Area 10 Agency on Aging’s mission is to serve as a leader in providing resources, solutions and connections for seniors, persons with disabilities and family caregivers living in Monroe and Owen counties|
|Area 7 Agency on Aging and Disabled West Central Indiana||Phone: 812-238-1561||Thrive is responsible for developing, managing and implementing many federal, state and local programs throughout West Central Indiana|
|Area Five Agency on Aging & Community Services, Inc.||Phone: 800-654-9421
email: [email protected]
|Area Five strives to improve the lives of the people in their community by empowering them through education programming and the elimination of barriers|
|Area IV Agency on Aging & Community Action Programs, Inc.||Phone: 765-447-7683||Area IV Agency on Aging and Community Action Programs, Inc. is committed to providing services to our communities’ most vulnerable individuals. We offer services that will address individual needs and create equal opportunities for those we serve|
|CICOA Aging & In-Home Solutions||Phone: 800-432-2422||CICOA is making a difference for Central Indiana’s seniors and people with disabilities by providing meals, transportation, home modifications, and in-home care to remain comfortably and safely at home|
|Generations Vincennes University Statewide Services||Phone: 812-888-5880||Generations provides information and services to older adults, individuals with disabilities of any age and their caregivers in Daviess, Dubois, Greene, Knox, Martin and Pike counties|
|Hoosier Uplands/Public Service Area 15 Agency on Aging and Disability Services||Phone: 812-849-4447||The mission of Hoosier Uplands, is to plan, implement or cause to be implemented, and provide comprehensive services to the poor, elderly, and disabled|
|Lifespan Resources, Inc.||Phone: 812-948-8330||LifeSpan Resources will be the key organization in Southern Indiana supporting independence and quality of life for all persons through advocacy, education and client centered services|
|LifeStream Services, Inc.||Phone: 765-759-1121||LifeStream Services is a nationally accredited, award-winning non-profit that offers a variety of programs and services to help people at risk of losing their independence, their families, and their communities in East Central Indiana|
|LifeTime Resources, Inc.||Phone: 877‑234‑3641||Our professional staff is experienced in assisting families with identifying resources, and we do so with an emphasis on our core values: compassion, cooperation and commitment|
|Northwest Indiana Community Action Corporation||Phone: 800.826.7871
email: [email protected]
|Northwest Indiana Community Action Corporation’s mission is to help people to be independent and advocate for those who can’t|
|REAL Services, Inc.||Phone: 574-284-2644
email: [email protected]
|REAL Services forges a community in which individuals are empowered to maintain their independence and find meaning and satisfaction throughout their lives|
|SWIRCA & More||Phone: 812-464-7800||SWIRCA & More’s mission is to develop a comprehensive array of services which will prevent inappropriate institutionalization and encourage self-sufficency among adults 60 and over as well as disabled youths and adults|
|Thrive Alliance||Phone: 866-644-6407||The mission at Thrive Alliance is to improve the quality of life and health for people at risk of losing their independence|
|Resource||Contact||How they help|
|CMS Medicare Managed Care Appeals & Grievances||N/A||Provided by the CMS, this page provides information related to dealing with Medicare managed care plan grievances and appeals|
|CMS Medicare Managed Care Eligibility and Enrollment||N/A||Provided by the Centers for Medicare & Medicaid Services (CMS), this page offers information for contacting MAP organizations plus other health plans and related aspects to Medicare health plan enrollment|
|CMS Medicare Prescription Drug Eligibility and Enrollment||N/A||Provided by the CMS, this page details prescription drug eligibility and enrollment as it relates to MAP|
|Medicare.gov||Phone: 800-633-4227||The homepage for the main Medicare website for the U.S|