Medicare Advantage Plans in Indiana

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. 

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. 

*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.

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.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources