Indiana Medicare Guide

Learn about your options and get support enrolling in the best Medicare coverage for your needs. Call us today at (888) 604-0055 or schedule a free consultation with one of our licensed Indiana Medicare Advisors here.

Below you’ll find information about Indiana Medicare options and enrollment to help you make your Medicare decisions.

Use this table of contents to jump to specific sections:

A Snapshot of Medicare in Indiana

There are 1.3 million Medicare beneficiaries in Indiana, making up 19% of Indiana’s total population. 17% of Indiana Medicare beneficiaries are also receiving support from Medicaid, which we’ll explain in more detail later.

Medicare Advantage vs. Original Medicare in Indiana

When you first get Medicare, you enroll in Part A and Part B, which make up Original Medicare. You have a choice to stay on Original Medicare (with or without supplemental coverage) or to switch to a Medicare Advantage plan. Each path has its pros and cons, which we’ll explain in the next couple of sections. As for Indiana Medicare recipients, 60% choose to stay on Original Medicare and 40% choose to enroll in a Medicare Advantage plan (source).

Indiana Medicare Advantage Plans

Medicare Part C is commonly referred to as Medicare Advantage (MA). MA plans replace Original Medicare (Part A and B) and must legally provide the same amount of coverage. MA plans are popular, in part, because they generally offer additional benefits, including prescription, dental, vision, and hearing coverage. Before you enroll in a Medicare Advantage plan, it’s important to know about their disadvantages. Some drawbacks of MA plans include limited networks, preauthorization requirements, and higher out-of-pocket costs. MA plans can change every year, and so can your plan choice. During the annual Open Enrollment Period, which occurs every fall, you can explore other plans and make a change without consequence.

40% of Medicare beneficiaries choose to enroll in one of the 108 Medicare Advantage plans available in Indiana. Plan pricing and availability varies by county. For example, in 2023, Marion County has 50 Medicare Advantage plans available with monthly premiums ranging from $0 - $187. Allen County has 42 with premiums from $0 - $82. To hear about available Medicare Advantage plans in Indiana, give us a call at (888) 604-0055, or schedule an appointment with one of our licensed Indiana Medicare Advisors.

Indiana Medicare Supplement Plans

Original Medicare only pays for about 80% of the cost of covered services and has no out-of-pocket maximum. For this reason, many individuals with Original Medicare add a Medicare Supplement (Medigap) plan to help cover the remaining 20% of costs. Medicare plans don’t provide coverage for additional health services, but they significantly reduce what you pay for covered services. For example, if you enroll in a Medigap Plan G (one of ten types of Medigap plans) you’re only responsible for paying your Part B deductible, which is $226 in 2023. Medicare will pay for everything else. You can learn more about the ten types of Medigap plans here.

In addition to better financial predictability through lower out-of-pocket costs, Medigap plans don’t have networks. This means you can see any doctor who accepts Medicare, which is about 90% of all doctors nationwide. This is particularly important if you travel a lot or often visit family out of state. Unlike most Medicare Advantage plans, if you’re on Original Medicare + Medigap you don’t need to get prior authorization.

The best time to enroll in a Medicare Supplement plan is during the Medigap Open Enrollment period, which is the first six months after you get Part B. During this time you have a guaranteed issue right. This means that insurance companies cannot deny you coverage based on your age or medical history. If you decide you want to enroll in a Medicare Supplement plan later on, however, insurance companies can ask you questions about your health history and you could be denied coverage.

Indiana Part D (Prescription Drug Coverage) Plans

We tend to need more prescriptions as we age, but unfortunately, Original Medicare doesn’t provide prescription coverage. That’s why Medicare Part D was introduced.

Medicare beneficiaries can receive prescription drug coverage through either a Medicare Advantage plan that includes prescription coverage (MAPD plan) or through a stand-alone Part D plan. Indiana Medicare beneficiaries have access to 24 stand-alone Part D plans, but the exact number available to you will depend on your county.

If you don’t currently need any prescriptions, you may be thinking about signing up for prescription coverage later on when you do. We recommend enrolling in a low-cost plan to avoid the Part D late enrollment penalty.

How to save on prescription drug coverage

If you need regular prescriptions, the costs can add up! Medicare’s Extra Help program offers support for those who have limited incomes and resources. We’ve also shared some other ways you can save, regardless of your financial status.

Medicare Extra Help Program

Medicare’s Extra Help program is also commonly referred to as the Part D Low-Income Subsidy (LIS). It helps Medicare beneficiaries with low income and resources pay for the costs associated with their prescription drug coverage.

You qualify for Extra Help automatically if you get:

Full Medicaid coverage from Indiana
Help from Indiana to pay your Part B premium
Supplemental Security Income (SSI) benefits

You can learn more about eligibility and how to apply for Extra Help here. One of our licensed Indiana Medicare Advisors can also help you determine if you should apply and assist with the application process.

Other ways to save on prescriptions in Indiana

Check pricing at other pharmacies - Just like any other product, pharmacies have different prices for prescriptions. Check other convenient pharmacies, including mail-order pharmacies, to be sure you’re getting the best price!
Switch to comparable medications - Many people know that switching to a generic version of a brand-name medication can save you money. Sometimes just switching the type of prescription you take (e.g., pill vs softgel) can result in big savings!
Look at other drug plans each year - Medicare plans change every year, and so may your prescription needs. Work with a licensed Medicare advisor to review changes to your plan and other plans each year to be sure you’re getting the best value from your drug plan.

Get help paying for Medicare in Indiana

The Medicare Extra Help Program only helps with prescription costs. Medicaid and SSI Benefits can help you cover the costs associated with Medicare.

Medicaid

Medicaid is a state-run program that’s supported by the federal government. Most states have a Medicaid program specifically for individuals who are aged, blind, or disabled (often called ABD). Indiana’s ABD program is called Hoosier Care Connect. Indiana Medicaid also has a program called HoosierRx which provides eligible individuals with help paying their medicare Part D premiums.

Medicare Savings Programs

Indiana Medicare Savings Programs are provided through the state Medicare program, which has two levels of help. The level of assistance you receive is based on your income. One level pays for your Part B Premium. The other level is commonly called the Qualified Medicare Beneficiary (QMB) program. This program pays for all of your Medicare premiums and out-of-pocket expenses. Click here to learn more about eligibility, benefits, and the application process.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

You are 65 and older, blind, or have a disability
You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

Indiana Medicare Eligibility and Enrollment Steps

Indiana Medicare eligibility requirements are the same as the rest of the United States. You’re eligible for Medicare if you’re a US citizen who meets one of the following criteria:

You’re 65 or older
You have certain disabilities, like End-Stage Renal Disease or ALS

Three key steps for Indiana Medicare enrollment:

Enroll in Original Medicare (Part A & Part B)
Choose your supplemental coverage
- Medicare Supplement (Medigap)
- Medicare Advantage (Part C)
- Part D (drug coverage)
Set yourself up for success by finding doctors, sharing your plan information with your pharmacy, and accessing additional benefits that come with your coverage.

If you’re eligible for Medicare by way of turning 65, you can enroll as soon as your Initial Enrollment Period (IEP) begins. Your IEP is a seven-month window surrounding your 65th birthday. It starts three months before the month you turn 65 and ends three months after it. In some cases, Medicare-eligible individuals may choose to delay their Part B enrollment. Learn more about whether or not that’s the right choice for you by reading through our guide for those new to Medicare.

If you have questions or want help exploring your Medicare options, our licensed Indiana Medicare Advisors are here to help! Schedule a free consultation or give us a call today at (888) 604-0055 to get started!

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