Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare Advantage allows seniors and adults with disabilities to combine all the benefits of Medicare Parts A and B into a single plan, known also as Medicare Part C. The primary difference is that Advantage plans aren’t managed by the federal government but by private insurance companies. Each Advantage plan must offer coverage that includes the benefits of Medicare Parts A and B, with the exception of hospice care, but insurance companies offer additional benefits with these plans, such as dental, vision, hearing, medical transportation and wellness programs.
Most Advantage plans offer prescription drug coverage, so seniors don’t need to take out Medicare Part D for that. Advantage plans must meet requirements set out by the Centers for Medicare and Medicaid Services, but private insurance companies can set their own annual out-of-pocket limits and rules regarding in-network service.
In 2020, almost 1.3 million adults were eligible for Medicare in Indiana. Of these people, almost 450,000 selected a Medicare Advantage plan, which represents almost 35% of Medicare enrollees. By comparison, the national average is 42%.
This guide explains what Medicare Advantage plans are, what they cover, who’s eligible to enroll in them and how seniors can find an Advantage plan that’s right for them.
The Top 10 Medicare Advantage Plans in Indiana
Several insurance providers offer Medicare Advantage plans in Indiana. Seniors in the state have access to a wide range of policies and plan types. The following table reviews the most popular insurance companies based on total enrollment in all Advantage plans. We’ve provided enrollment numbers from all plans offered by each insurer to show each company’s total enrollment in the state.
Since most insurance companies offer more than one type of policy, the costs displayed below are ranges instead of averages. This information is accurate as of April 2022. Seniors may visit Medicare.gov for more current information about the plans available in Indiana.
Name
Total Enrollment
Star Rating
Min Cost
Max Cost
Plan Types
UnitedHealthcare
197,513
4
$0
$24
HMO, PPO
Humana
143,997
4
$0
$136
HMO, PPO, PFFS
Anthem HealthKeepers
78,867
3.5
$0
$26
HMO
Aetna Medicare
62,943
3
$0
$29
HMO, PPO
Anthem Blue Cross and Blue Shield
33,997
4
$0
$80
PPO
Blue Cross Blue Shield of Michigan
20,170
0
$0
$0
PPO
Indiana University Health Plans
14,509
4.5
$0
$98
HMO
Wellcare by Allwell
7,596
3.5
$0
$25
HMO, PPO
Ascension Complete
2,295
0
$0
$0
HMO, PPO
Health Alliance Medicare
1,162
4
$0
$165
HMO
How Medicare Advantage Plans Work in Indiana
Prior to selecting an Advantage plan, it’s a good idea for seniors to familiarize themselves with how the Medicare Advantage program works and how to qualify. Insurance companies offer different types of plans, including the familiar health maintenance organization (HMO) and preferred provider organization (PPO) plans that most people already have experience with. Each health plan has its own rules regarding eligibility, which doctors plan members may see, how to get a referral to a specialist, which medications are covered and the need to establish primary care. Below is a review of the four most common types of Advantage plans.
What Medicare Advantage Plans Cover in Indiana
Aside from hospice care (which remains covered by Medicare Part A), Advantage plans are legally required to cover everything offered by Medicare Parts A and B. This includes preventative care, emergency room visits, inpatient care, outpatient procedures, diagnostic testing and medical equipment and supplies. Medicare Advantage plans often include prescription drug plans, coverage for dental, vision and hearing care, and discounts on wellness programs, such as meal services and gym memberships.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Indiana
Before seniors can apply for Medicare Advantage, they need to already be enrolled in Original Medicare (Parts A and B) and live in the service area for the plan they’ve selected. They must meet all other Medicare enrollment requirements and the eligibility requirements for the Advantage plan they’ve chosen. Medicare is only provided to seniors over the age of 65 and adults with qualifying disabilities. It’s also only accessible to U.S. citizens and legal residents.
Medicare has an initial enrollment period and annual enrollment periods that allow seniors to make changes to their plans. It’s important for seniors to know when they can enroll and how to avoid late enrollment penalties. The list below reviews enrollment periods and timing.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Indiana
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Indiana’s Senior Health Insurance Program provides free, unbiased health insurance information for those who qualify for Medicare. It is staffed with a team of volunteer counselors who have completed an intensive training course and are certified by the Indiana Department of Insurance. SHIP isn’t affiliated with any insurance companies or agencies, and it doesn’t sell insurance plans. Some services that it provides include help with understanding Medicare and organizing records, information on how to file Medicare claims and appeal Medicare decisions and an overview of a Medicare beneficiary’s rights. Its counselors also assist clients in evaluating the various Medicare Advantage plans available to them and provide referrals to appropriate agencies that address other needs. To be eligible for assistance from SHIP, seniors must qualify for Medicare coverage. SHIP also offers educational materials and brochures and provides speakers to make presentations for groups, clubs and senior centers.
To locate their nearest SHIP office, seniors should call 1-800-457-8283 or text 1-855-463-5292.
Managed Health Services
MHS Indiana is the state’s managed care entity that provides access to health insurance for at-risk populations, including low-income residents and seniors. It is a subsidiary of Centene Corporation, a multinational health care enterprise that offers government-sponsored health insurance and specialty services. Through MHS, seniors can enroll in Allwell, the state’s Medicare Advantage plan, as well as Medicare’s Extra Help program, which covers prescription drug costs for low-income seniors. MHS also connects Hoosiers with experienced case managers who can help them evaluate their needs and choose the best health care plan, as well as member service representatives who can help them understand their coverage or file a claim. Program eligibility is based on an individual’s age, and in some cases, special health needs. MHS also has a 24-hour nurse line that seniors can call to receive medical advice.
The AdvoConnection Directory provides a comprehensive list of private independent health advocates throughout Indiana. This free directory features nonmedical advocates and navigators who are members of the Alliance of Professional Health Advocates and have experience in helping clients work with medical providers and health insurance companies. Some services that advocates may provide include accompanying clients to medical appointments, helping them learn more about their medical condition, teaching pain management techniques and reviewing their prescriptions and over-the-counter medications to ensure that there are no conflicts. Advocates may also provide assistance with selecting a Medicare Advantage plan, filing a claim, disputing denials and finding legal assistance after a medical error. This directory is available to anyone, regardless of age, income or health status. TheAdvoConnection Directory also provides a variety of informational resources on topics, such as long-term care, preparing for hospital stays and reporting medical events.
Contact Info
To find an advocate, seniors can visit the AdvoConnection website, enter their zip code and select the services they’re looking for from the menu. Once the search results are provided, seniors can select the service provider that meets their needs and contact them directly.
Local Medicare Advantage Resources
LifeTime
LifeTime, which is located in Dillsboro, Indiana, provides a variety of services and supports for seniors residing in Dearborn, Jefferson, Ohio, Ripley and Switzerland Counties. It has a team of Family Support Options Counselors that provide free, objective advice to help seniors evaluate their needs and budget to find a suitable Medicare Advantage plan. To be eligible for services through LifeTime, seniors must be at least 60 years old and reside in the agency’s service area. Along with Medicare counseling, LifeTime provides transportation services, meal delivery, advocacy and community care counseling, as well as information and assistance. It provides referral services to connect seniors with other relevant community resources. The office also features an on-site resource library with books, videos and pamphlets on topics, such as family caregiving, as well as a computer with Internet access that is available to use during the library’s hours of operation.
CICOA Aging & In-Home Solutions is located in Indianapolis and serves seniors living in Boone, Hamilton, Hancock, Johnson, Marion, Morgan and Shelby Counties. This nonprofit organization has an Aging and Disability Resource Center that provides one-on-one counseling for seniors regarding available health care benefits and long-term services. The agency makes this service available for free to everyone, regardless of their income or financial assets. In addition to providing information about Medicare Advantage plans, the agency promotes seniors’ independence and wellness through several options programs, including home accessibility modifications, transportation and senior meals and nutrition services, as well as care management and care coordination services. It also provides presentations and display materials for community events.
Seniors can contact CICOA’s Indianapolis office by calling 1-317-254-5465 or 1-800-489-9550 on weekdays from 8:00 a.m. to 5:00 p.m. Seniors can also call the Morgan County office at 1-317-803-6061. To speak to someone about options counseling, seniors should call the agency’s Aging and Disability Resource Center at 1-317-803-6131 or 1-800-432-2422.
St. Joseph Health System
The St. Joseph Health System, which is based out of the northern region of Indiana, provides health insurance services to Michiana seniors. It features resource centers in Mishawaka, Plymouth and South Bend, each staffed with licensed health insurance agents who provide information on Medicare and prescription drug plans. All services are offered free of cost or obligation, and they are available to all Michiana residents regardless of age or income. Along with providing information on Medicare Advantage plans, it educates clients about vision, dental, cancer and critical illness insurance to help them reduce out-of-pocket medical expenses. No application or appointment fees are charged. It also hosts free events throughout the year where licensed health insurance agents answer visitors’ questions about Medicare and other types of health insurance.
For more information and to schedule an appointment with a health insurance agent, seniors should call 1-855-887-5633 or send an email to [email protected].