When it comes to health coverage, there are many pros and cons. You need to consider what you want and what your budget can handle before choosing a plan.
Indiana has a state exchange that offers a variety of health insurance options. The best plan for you is dependent on your medical needs, financial situation and the region in which you live.
Cost
The cost of health coverage in Indiana is based on the plan you choose, your deductible and copayments, and where you live. Rates vary for different ages and families.
Insurance isn’t free in Indiana; it can be expensive for those who don’t qualify for Medicaid or Medicare, but it is relatively affordable for everyone else. The state also offers multiple options for elderly residents and people with disabilities to obtain health insurance.
Depending on your income, you may qualify for a tax credit or cost-sharing reductions to help lower your monthly premiums. Moreover, you can apply for a Special Enrollment Period to purchase an ACA-compliant plan after certain life events such as marriage or having children.
The best option for most individuals in Indiana is a Gold plan, which has lower deductibles and copayments than Silver plans. You’ll pay a higher premium for Gold plans, but you’ll likely save money in the long run because of the lower out-of-pocket costs.
Coverage
Whether you’re a young or elderly resident, the state of Indiana offers a variety of options for health coverage. You can get a private plan through an employer or government agency, or you can buy a policy on the Indiana exchange.
In the private market, health plans are divided into metal tier systems, which determine how much of the medical expenses that the insurer covers and the amount that you pay out-of-pocket. You can choose from a range of affordable options that will help you cover unexpected medical costs without breaking the bank.
A Gold plan is the highest tier and typically has more expensive monthly premiums, but it also offers significantly lower out-of-pocket expenses than a Silver or Bronze plan. This makes Gold plans ideal for people who are likely to have high recurring medical costs, such as expensive prescriptions, or who may be worried about unexpected out-of-pocket costs.
Residents with incomes up to 138% of the federal poverty level are eligible for cost-sharing reductions (CSRs), which can reduce their out-of-pocket maximums, deductibles and copayments. CSRs can make a Silver plan more affordable for many people.
Preventive care
Having preventive care services like annual check-ups, screenings and vaccinations can help you stay healthy, avoid or delay illnesses and diseases, and keep conditions from getting worse. Preventive care is important for everyone, regardless of age or health risk factors.
Depending on your personal and family needs, your doctor may recommend other preventive services. The National Institutes of Health developed guidelines to help you and your doctor make informed decisions about the care that’s right for you or your family.
Most health plans are required to cover recommended preventive care at 100%, meaning you won’t be charged a copayment or deductible for these services. The rules apply to all health plans, not just those offered through the individual marketplace.
The Affordable Care Act outlines which preventive services health plans must cover. These include evidence-based preventive services ranked by the U.S. Preventive Services Task Force, as well as routine vaccines recommended by the Advisory Committee on Immunization Practices.
Out-of-pocket expenses
Out-of-pocket expenses are the costs associated with medical care that aren’t covered by your health insurance. They include deductibles, copays and coinsurance.
The type of plan you choose can impact how much you’ll pay out-of-pocket for medical services. The best plans will have low deductibles and maximums, which will help you save money on out-of-pocket expenses while also allowing you to access more benefits with your insurance.
Indiana residents can apply for Medicaid and the Children’s Health Insurance Program (CHIP). Both programs cover preventive care, immunizations, medications and mental health treatment.
If you’re a family, you can also qualify for Medicaid if your household income falls within certain guidelines. The income threshold depends on the number of members in your household.
You can also get lower out-of-pocket expenses with a Silver plan. These policies have a 70/30 split between the insurer and the policyholder, which makes them a good choice for those who want more coverage while reducing their monthly premiums. They’re even cheaper for residents who qualify for cost-sharing reductions.
