Since it was first introduced, Medicare Advantage (MA) has grown more popular every year. Almost half of the eligible Medicare population had an Advantage plan in 2022, which is more than one-third of all Medicare beneficiaries. This page explains Medicare Advantage plans in Indiana and how to compare your options to ensure you get the best plan for your unique needs.
What Is Medicare Advantage in Indiana?
Also known as Medicare Part C, every Advantage plan must provide the same coverage you have under Original Medicare. This includes:
- Medicare Part A, hospital insurance
- Medicare Part B, medical insurance
Prescription drug coverage is provided by Medicare Part D.
Medicare Advantage Plans with Prescription Drug Coverage in Indiana
Medicare Advantage Prescription Drug plans (MA-PD) combine your Medicare Parts A, B, and D benefits into a single policy.
Many Advantage plans also offer additional coverage. Popular add-on benefits include:
- Fitness programs
- Hearing aids
- Routine dental care
- Routine vision care
As private insurance companies provide Medicare Advantage plans, coverage varies according to the plan you choose.
Who Is Eligible for Medicare Advantage in Indiana?
If you have Medicare Parts A and B, you're eligible for Medicare Advantage in Indiana.
American citizens and permanent legal residents aged 65 and older are eligible for Medicare. If you began collecting Social Security benefits at least 4 months before turning 65, enrollment in Parts A and B is automatic.
You may qualify for Medicare before your 65th birthday if you collect Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months. Enrollment occurs automatically in month 25.
When Can You Sign Up for a Medicare Advantage Plan in Indiana?
Signing up for a Medicare Advantage plan in Indiana is restricted to specific enrollment periods.
Your Initial Enrollment Period (IEP) lasts for 7 months, beginning 3 months before you qualify for Medicare. As an example, if your 65th birthday or 25th month of collecting disability occurs in February, your IEP starts on November 1 and ends on May 31.
If you miss your IEP, the General Enrollment Period lets you sign up for Part A and/or Part B from January 1 until March 31. After General Enrollment ends, you may join a Medicare Advantage plan from April 1 until June 30.
Medicare's Annual Enrollment Period (AEP) runs from October 15 through December 7 and allows current beneficiaries to make any changes needed to their Medicare coverage. This includes joining an Advantage plan.
The Medicare Advantage Open Enrollment Period is for people currently enrolled in Part C. It runs from January 1 through March 31. Options include joining a new MA plan or returning to Original Medicare. You can also enroll in a standalone Part D plan if you lose your prescription drug coverage after making that change.
Special Enrollment Periods let you join a Part C plan if you experience certain life changes, such as moving or losing your current coverage. Find the full list of qualifying circumstances on Medicare.gov.
Types of Medicare Advantage Plans in Indiana
There are four main types of Medicare Advantage plans in Indiana.
- Health maintenance organizations: HMO plans use a provider network that may include any entity that offers healthcare services. They also require plan members to choose a primary care doctor and get a referral to see a specialist. Services from out-of-network providers are rarely covered by an HMO unless it's an emergency.
- Preferred provider organizations: PPO plans also have provider networks. However, members may use an out-of-network provider for a higher cost. PPO plan members also don't need a primary doctor or specialist referrals.
- Private fee-for service: PFFS plans establish cost guidelines for covered services, including what plan members pay. Most PFFS plans have a provider network but allow members to use an out-of-network provider for a higher cost. However, out-of-network providers may refuse to treat you barring medical emergencies.
- Special needs plans (SNPs) limit enrollment to people who meet certain criteria. These vary by plan, but generally amount to having a chronic condition, living in an institution, or qualifying for both Medicare and Medicaid. Most SNPs also require beneficiaries to choose a primary doctor. If you qualify for an SNP, you may join the plan at any time.
How to Choose a Medicare Advantage Plan in Indiana
To ensure you get the best Medicare Advantage plan for your particular needs, consider these four metrics:
- Costs: These may include an annual deductible, monthly premiums, and copays or coinsurance.
- Coverage: Benefit vary widely, so compare your options carefully. Don't forget the drug formulary for MA-PD plans.
- Network: Providers may enter and exit networks throughout the year.
- Ratings: Medicare rates plans on a 5-point scale to help members compare their options.
It's easy to compare Medicare Advantage plans in Indiana with our Find a Plan tool. Just enter your location information and estimated coverage start date to review the Medicare plan options in your area.
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