Types of Indiana health insurance

Indiana doesn't operate its own health care marketplace exchange. Instead, it relies on the federal marketplace exchange at Healthcare.gov.

Indiana residents can select from four different health insurance tiers based on costs:

  • Bronze -- Lowest premiums but highest out-of-pocket costs; plans pay 60% of your medical expenses.
  • Silver -- Low premiums and higher out-of-pocket costs than Platinum or Gold; plans pay 70% of your medical expenses.
  • Gold -- Low out-of-pocket costs but high premiums; plans pay 80% of your medical expenses.
  • Platinum -- Lowest out-of-pocket costs, but highest premiums; plans pay 90% of your medical expenses.

Choosing the metal tier that's best for you depends on several criteria, such as your financial state, health status, coverage goals and how often you plan to use your insurance.

When you may want to consider a Bronze plan:

  • You’re young and healthy and don't expect to require many health care services.
  • You wish to pay the lowest premiums possible.

When may want to opt for a Silver plan:

  • You desire cheaper premiums but want to avoid high out-of-pocket expenses.
  • You have a household that's eligible for additional subsidies found in Silver plans.

When you may want a Gold plan:

  • You don't mind paying higher premiums in exchange for spending less when you require health care services.
  • You anticipate needing several health care services over the next plan year.

When you may prefer a Platinum plan:

  • You desire to pay the lowest out-of-pocket costs when you need health care services but don't mind paying the highest premiums.
  • You expect to visit a physician often, need multiple prescription medications and utilize several health care services.

Best health insurance in Indiana

In 2021, there are three insurers offering plans in Indiana on the federal health care exchange:

  • CareSource -- Offers plans statewide
  • Ambetter -- Offers plans statewide
  • Anthem -- Offers plans only in Lake, LaPorte and Porter counties

Choosing which insurance company and plan is right for you depends on your health care needs and goals. To make a more informed decision, it helps to ask yourself important questions, such as:

  • Do I want to pay lower premiums or lower out-of-pocket costs when you need care?
  • Are my preferred doctors and providers participating in the plan's network?
  • Does the plan cover my prescription medications?
  • Is a referral required to see a specialist?

There are three different plan types on the federal exchange available to Hoosiers (PPOs are not an option):

  1. Health maintenance organization (HMO) plans: These plans typically are less expensive than EPOs, but they’re more restrictive. You will likely be required to choose a primary care physician and obtain referrals from that provider if you want to see a specialist in the network. Also, HMOs commonly don't cover costs for out-of-network care unless it's an emergency.
  2. Exclusive provider organization (EPO) plans: EPOs function as a hybrid of HMOs and PPOs. As with an HMO, you’re required to remain within your plan's network. However, you don't have to select a primary care physician or obtain referrals for visits to a specialist.
  3. Point of service (POS) plans: You pay less if you use physicians, hospitals and other health care providers within the plan's network. But POS plans obligate you to obtain a referral from your primary care physician if you want to see a specialist.

Find out more about the differences in the health plan types.

If you need dental coverage, you can also opt for dental insurance through the federal marketplace. But you need to sign up for an ACA health care plan to be eligible for a dental plan available on the federal exchange.

After enrolling in a health care plan at Healthcare.gov, you can shop around for available dental plans on the same website.

Indiana has no individual mandate or penalty

Back when it was first put into law, the ACA had an individual mandate that required most Americans to have health care insurance or pay a fee at tax time. Congress has eliminated the individual mandate penalty on the federal level.

Some states now require health insurance, but Hoosiers don’t need health coverage. Even though you aren't required to get health insurance, having coverage in place is a smart strategy. That's because it can be astronomically expensive to pay for a hospital stay, surgery, emergency care, doctor visits, prescription drugs and other health care-related costs completely out-of-pocket.

You are twice as likely to file for bankruptcy when your health insurance is interrupted, according to an American Bankruptcy Institute study.

Expanded health insurance subsidies in Indiana

Americans benefit from cost-saving subsidies in the ACA exchanges if their household income qualifies. These subsidies help cover premium costs and decrease out-of-pocket costs.

Two examples of subsidies you may qualify for are based on your income and other factors include:

  • Premium tax credits that decrease your monthly premiums. The credit can be taken in full when you file your taxes for that tax year or a portion of the credit can be applied monthly to your insurance plan to lower your premium.
  • Cost-sharing reductions (CSRs) that lower your out-of-pocket expenses. CSR payments from the federal government are made to your insurance company to help reduce your costs. You can qualify for CSRs if you make 250% or less of the Federal Poverty Level (FPL) and you select a Silver level plan.

In Indiana, adults with household incomes of approximately 138% of the FPL or less can apply for Medicaid or other health care coverage through the state of Indiana. Indiana adults with household incomes between approximately 138% and 400% of the FPL may qualify for subsidized coverage at Healthcare.gov.

Indiana adults with household incomes over 400% of the FPL can for coverage through the federal health exchange but may also seek coverage through the individual private health insurance market.

Household incomeEligible for MedicaidEligible for subsidized Obamacare coverage
1Less than $17,819.34$17,819.35 - $51,040
2Less than $24,075.66$24,075.67-$68,960
3Less than $30,331.98$30,331.99-$86,880
4Less than $36,588.30$36,588.31-$104,800
5Less than $42,844.62$42,844.63-$122,720
6Less than $49,100.94$49,100.95-$140,640
7Less than $55,357.26$55,357.27-$158,560
8Less than $61,613.58$61,613.59-$176,480

Source: State of Indiana

Indiana Households beneath subsidy eligibility may qualify for the state's Medicaid program, Healthy Indiana Plan (HIP), which offers low-cost health care coverage to families and individuals who are eligible based on household income.

How much is health insurance in Indiana?

The costs for health care insurance in Indiana differs based on several factors, including premiums, deductibles, out-of-pocket costs, where you live and how you receive coverage.

Below are the differences in average lowest premium costs in 2021 for three of the metal tiers offered:

  • Bronze -- $333
  • Silver -- $400
  • Gold -- $592

Source: Kaiser Family Foundation

Estimates for Platinum plans, which only represent a small portion of ACA plans, were not provided by the Kaiser Family Foundation.

Be aware that these average costs don't take into account applicable subsidies. Keep in mind that if you’re eligible for subsidies, it's likely that you'll pay much less than these average premium costs.

Indiana hasn’t published median premium costs for its various counties.

How to buy health insurance in Indiana

In Indiana, you can get a health care plan through the federal marketplace at Healthcare.gov during open enrollment, which runs from Nov. 1 to Dec. 15 each year.

More than 140,000 Indiana residents enrolled in an Obamacare plan through the federal exchange in 2020.

The good news is that, even though the most recent deadline has passed, the Biden administration recently issued an executive order that creates a special enrollment period, Feb. 15 through May 15, 2021 for health care plans sold via Healthcare.gov.

Also, you can sign up for an ACA plan through the federal exchange at other times of the year if you qualify for a special enrollment period because you:

  • Lost your job
  • Lost your health insurance
  • Moved
  • Turned 26 and aren’t eligible to remain on your parents' plan
  • Got married or entered into a domestic partnership
  • Became the parent of a newborn
  • Were impacted by wildfires
  • Became a U.S. citizen
  • Experienced a change in household size
  • Returned from active military service
  • Were released from jail or prison

If you qualify, you will have 60 days to enroll or make changes to your health care plan. To enroll, visit Healthcare.gov, phone 800-318-2596 or apply with a certified enroller or broker. Be sure to collect the following documents first:

  • Social Security numbers or immigration documents
  • Federal tax information (if you file)
  • Employer and income information for your household

COBRA insurance in Indiana

Have you recently suffered a job loss from a company that provided employer-sponsored group health care insurance? Fortunately, you may qualify for enrollment in a COBRA plan if your former employer had 20 or more employees. This option enables you to continue that plan and maintain coverage for a limited period -- usually between 18 and 36 months.

You get to keep your health insurance but COBRA comes with caveats. Namely, you’re responsible for all the costs -- including premiums, copays, deductibles and prescription drugs. Your former employer will not contribute funds to help offset these costs.

Unlike most states, Indiana doesn’t have a mini-COBRA law to help former employees of businesses with fewer than 20 employees. Instead, you’ll have to get coverage elsewhere, including the ACA exchange, a short-term health insurance or Medicaid if you’re eligible.

Other ways to get health insurance in Indiana

Obamacare, Medicare, Medicaid, Healthy Indiana Plan coverage and employer-sponsored group plans aren't your only options for health care coverage in Indiana. You can also pursue:

Individual private plans purchased directly from a health insurer may provide alternative plan choices. However, these plans don't qualify for subsidies. That's why, if you’re eligible for subsidies, it's probably best to shop around for a plan offered at Healthcare.gov.

At a minimum, it's worth exploring a catastrophic plan, which is available to applicants younger than age 30 or those who qualify for a hardship exemption. Catastrophic plans offer many benefits similar to what's included in a conventional health care plan. The downside is that they come with much costlier out-of-pocket expenses. If you qualify, you can enroll in a catastrophic plan directly with an insurer. Before you do, however, note that a Bronze plan might be a better option, as:

  • You may qualify for subsidies with a Bronze plan.
  • Premiums are similar for Bronze plans and catastrophic plans.
  • Deductibles may be lower with a Bronze plan.

Alternatively, consider a short-term health plan. These plans entice with low premiums but come with higher out-of-pocket costs. Also, they don't often cover health care services like maternity care, mental health and prescription medications. In Indiana, short-term plans can have initial terms up to 364 days and are renewable for up to three years.

Still have questions about eligibility for health care insurance Use Insurance.com's Health Plan Finder tool to investigate your health insurance eligibility.