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Medicare in Indiana

Get speedy answers to your Medicare questions

Reviewed by: Malinda Cannon, Licensed Insurance Agent. Written by: Bryan Strickland.

Key Takeaways

  • Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). in Indiana is an option at age 65. It features hospital (Part A) and medical (Part B) coverage with the option of adding drug (Part D) and supplemental (Medigap) coverage.

  • Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plans in Indiana bundles the coverages available on Original Medicare while offering additional coverages like dental and vision care.

  • Indiana Medicaid offers some similar services, but eligibility is based on need regardless of age.

 

An oval track and a round ball – the Indianapolis 500 and the Indiana Hoosiers basketball program — lie at the heart of Indiana’s identity.

But if you feel like Medicare in Indiana has you running in circles, GoHealth is here to help get you on track.

Who Qualifies for Medicare in Indiana?

If you’re a U.S. citizen and are age 65 or older, you qualify for Medicare in Indiana. It’s as simple as that.

But what exactly does that qualify you for?

Medicare is a federal program launched in 1965 to provide affordable healthcare for older Americans nearing retirement. At age 65, you can enroll in Part A (also known as “hospital insurance”), Part B (“medical insurance”) or both.

Once enrolled in Part A and B (known collectively as Original Medicare), you have the option of switching to a Medicare Advantage plan in Indiana (also known as Part C) to receive the benefits of Parts A and B from a private insurance company along with other benefits like dental and vision coverage.

If you decide to stay enrolled in Parts A and B, you have the option to add Part D to cover a portion of your prescription expenses. You also may choose to add Medigap insurance, which is supplemental coverage that helps fill in the gaps that exist in terms of out-of-pocket expenses like copays and coinsurance.

Medicare Advantage in Indiana bundles Parts A, B, and D and supplemental coverage.

How do I apply for Medicare in Indiana?

Your choices for applying for Medicare in Indiana include:

  • Enrolling online with the Social Security Administration. [1]
  • Visiting a local Social Security office. [2]
  • Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).

If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply. Your first chance to sign up is during your Initial Enrollment Period, which is a seven-month window that includes the month of your 65th birthday as well as the three months before and the three months after your 65th birthday.

What Qualifies You for Medicaid in Indiana?

Each state has its own plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. The state of Indiana takes an active role in the implementation of Medicaid, with Indiana Medicaid providing several options for residents in need.

The Indiana Family & Social Services Administration has an online Eligibility Guide [3] that helps residents determine which Medicaid program may fit their individual needs.

What Qualifies a Patient for Medicare?

Medicare, in addition to being available to all U.S. citizens in Indiana age 65 or older, is offered to residents facing some specific health challenges.

You may be eligible for Medicare in Indiana regardless of your age if:

What Medicare Plans are Required at 65?

Enrolling in Medicare at age 65 isn’t required, but there are reasons you might want to enroll even if you have other healthcare coverage.

  • Part A of Original Medicare provides coverage for hospital stays and doesn’t require a monthly premium for anyone who has worked at least 10 years. If you fit into that common category, while it isn’t required that you enroll at 65, there is value in doing so.
  • Part B of Original Medicare provides coverage for medical expenses but does require a monthly premium (which was $148.50 in 2021). Some people don’t enroll at age 65 because they have similar insurance provided by an employer. In that case, you’ll have a Special Enrollment Period when your employer coverage ends.If you don’t enroll at 65 otherwise, you could be responsible for a 10% late enrollment penalty for every 12 months you wait to enroll.

What is the Most Popular Medicare Advantage Plan?

If you’re on Original Medicare but are pondering a switch to Medicare Advantage in Indiana, here are some things to consider.

  • Medicare Advantage plans bundles the hospital and medical coverage offered by Parts A and B of Original Medicare in IN, as well as the drug coverage and supplemental coverage that can be added to Original Medicare.
  • Medicare Advantage plans also can offer additional coverage options not offered by Original Medicare like dental and vision coverage and a monthly stipend for purchasing over-the-counter supplies.
  • Medicare Advantage plans and Original Medicare have different coverage areas and different costs. While Original Medicare can be used nationwide, Medicare Advantage is usually limited to a network of providers in your area, but that distinction allows Medicare Advantage in Indiana to often offer more affordable options.

The Centers for Medicare and Medicaid Services has a Medicare Star Rating system that assigns a rating of one to five stars (five being the highest-rated) to individual Medicare Advantage plans. If you’re already on a Medicare Advantage plan and it’s not five-star, you are offered one opportunity to switch to a five-star plan each year. [4]

While the rating system can shed light on the performance of Medicare Advantage plans, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent, without obligation, can help you compare plans and find the one that’s the right fit for you.

Medicare in Indiana by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 1,183,621 people are enrolled in Medicare in Indiana. The total number of beneficiaries enrolled in Medicare Advantage in Indiana is 385,308. The previous year, 340,838 enrolled in Medicare Advantage. Medicare Advantage participation in Indiana went from 29.37% to 32.55% year over year. If you’d like to dive deeper into how Medicare in Indiana breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Indiana
1,183,621
Beneficiaries with Part A & Part B
385,308
Medicare Advantage Beneficiaries
32.55%
Medicare Advantage Participation Rate
55.88%
% Female
44.12%
% Male
1.01
Average HCC Score
$10,200.33
Actual Per Capita Costs
20.74%
% Eligible for Medicaid
33.33%
% of Beneficiaries with an Emergency Department Visit
17.53%
Hospital Readmission Rate
89.28%
% Non-Hispanic White
6.25%
% African American
1.69%
% Hispanic
2.78%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Indiana Medicare Resources & Contacts

Beneficiaries spend an average of $10,200.33 each year on Medicare in Indiana. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Indiana-based resources, like these, may be able to help:

Indiana Department of Insurance

1-800-452-4800 (TTY: 1-866-846-0139)

https://www.in.gov/ship/index.htm

What should I know about the Indiana Department of Insurance?

Provides free advice about Medicare through the federally sponsored State Health Assistance Insurance Program.

Indiana Division of Aging

1-800-713-9023

https://www.in.gov/fssa/da/what-we-do/

What should I know about the Indiana Division of Aging?

Composed of 15 area agencies that assist Indiana seniors with a variety of needs, including healthcare-related ones.

Indiana Health Coverage Programs

1-800-457-4584

https://www.in.gov/medicaid/providers/461.htm

What should I know about Indiana Health Coverage Programs?

The state’s Medicare program offers and oversees several financial assistance programs to Indiana residents.

Indiana Department of Veterans Affairs

1-800-457-8283

https://www.in.gov/dva/3961.htm

What should I know about the Indiana Department of Veterans Affairs?

Helps veterans and their families understand and optimize their health-related benefits.

Nationwide Resources

Speak with an insurance agent that is licensed in Indiana about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in IN, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

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New to Medicare Guide

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Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

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For those helping a loved one with Medicare.