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Indiana Health Insurance

Indiana Medical Insurance Overview

Among the choices in health coverage for residents in Indiana are publicly funded programs, individual insurance plans and those that are sponsored by your employer.  The state has seen a good amount of improvement with regard to the health of its populace and healthcare reform has expected to increase the percentage of covered residents in this state.

The Patient Protection and Affordable Care Act will still provide many changing benefits through the year 2020, but it is expected to cover 30 million more U.S. citizens in the years ahead.

Indiana’s Health Care Issues
Indiana is ranked in the 40th spot in comparison to the other states in the U.S. with regard to the health of the state’s residents.  The state of Indiana ranked in the 37th position in 2011, but it has seen a significant drop in the overall health of those residing there.

Among the state’s strengths with regard to its health status are a high percentage of kids who have graduated high school, a high rate of vaccinations for MCV4 and a low incidence of Salmonella.  The state’s weaknesses are its low per capita health funding, its high prevalence of smokers and its high levels of air pollution.

Understanding Indiana’s Population of Uninsured Residents
According to information presented by the Henry Kaiser Family Foundation, 11 percent of the population of Indiana is without insurance benefits.  This is under the national average for citizens without insurance coverage, which is roughly 16 percent.
With regard to the uninsured population in Indiana, see the below statistics:

  • Indiana’s highest number of uninsured people is comprised of poor adults.  37 percent of poor adults living in this state have no benefits whatsoever.
  • 9 percent of the poor children and 9 percent of low income kids in this state have no insurance coverage.
  • Half of Indiana’s companies don’t offer group plans to their workers, leaving those affected to obtain insurance through other means.

Group Health Plans
Employer sponsored insurance coverage is being used by 51 percent of the people living in the state of Indiana.  If you have a job in Indiana, there is a decent chance that you will have access to a group health plan.  To find out if benefits are something offered by your workplace, check in with the personnel in the HR department.  You will find it beneficial to obtain coverage in this manner because of the coverage and cost options available.  Group plans work by spreading around the risk of insurance to a group of people so insurance costs end up lower overall.  Insurance companies who offer coverage through group plans are less restrictive with regard to who they offer coverage to and the plan’s options that are available.  If you have a pre-existing condition, you cannot be turned down for benefits under a group health plan.  The Department of Insurance regulates private insurance providers in the state of Indiana.

Signing Up
Signing up for coverage under your workplace’s group health plan is usually done during the company’s open enrollment period.  Find out when that period of time is from someone working in the company’s Human Resources department.  Choosing a quality health insurance option is a decision that requires a lot of thought, so consider the available options carefully.
Before you sign up for coverage, think about the following points:

  • Do you have chronic conditions that require medical care from your new plan?
  • Does your employer offer more than one option when it comes to insurance coverage?
  • Do you have to cover your spouse or children?  If so, bring this up early in the process to get them enrolled.

Pre-Existing Condition Exclusion Periods
Under a group health insurance program, you cannot be declined coverage because you have a pre-existing condition.  You may have to wait an exclusionary period of time, but this is typically no longer than a period of 12 months.

Keep the following points in mind concerning exclusion periods for pre-existing conditions in the state of Indiana:

  • Dependents that are 19 and younger are not subject to exclusion periods because of HIPAA.
  • Insurance companies can look back into your medical history for up to 6 months to determine whether or not you have a pre-existing condition.
  • In the absence of a diagnosis or treatment, genetic predispositions are not considered pre-existing conditions and cannot be treated as such.

Affiliation or Waiting Periods
On top of possible exclusion periods, you may be subjected to a waiting period after you go through the enrollment process.  This cannot typically go over two months except in the case of late enrollment, which is a three month waiting period.

Individual Health Plans
Individual plans are offered to people who cannot get coverage through their place of employment or through state-funded means.  Individual policies are subject to a great deal of underwriting on the part of the insurance company and can cost a lot of money to maintain.
Around three percent of insured people in Indiana are covered under individual policies.  It is harder to find this type of coverage because private insurance companies do a lot of underwriting and can usually deny you coverage if you have a pre-existing medical condition.

The Foundation for Health Coverage Education reveals that a healthy young non-smoker living in the state of Indiana can get insurance coverage for a minimum of $66 per month.  The maximum time that insurance providers can look back into your medical history is a year and the exclusion period can run as long as ten years for applicants who have a pre-existing condition.

Continuation Coverage
If you have lost your insurance status for any reason, you might be able to secure coverage under COBRA.  These are temporary benefits that cover you until you are able to obtain coverage otherwise or get continuation coverage under HIPAA.  Coverage under COBRA can run for 18 months following your last date of insurance coverage and eligibility solely depends on the size of the company that originally offered the insurance policy.

Indiana Health Benefits Exchange
Indiana abandoned plans for a state-run insurance marketplace and opted to use for coverage options for the residents living there.  Indiana is one of four states who have opted to take this route when offering benefits to its residents.

If you need health benefits in Indiana, you can use the federally managed marketplace in order to view your options for coverage and enroll into a plan.

Indiana State Insurance Programs
In addition to the group and individual insurance plans available, there are also some options for residents in the state of Indiana to receive coverage through state-funded programs.  For those programs that are run on a state level, your eligibility is based on your level of income, gender and whether or not you have any pre-existing health conditions.  Coverage is provided under these various state-funded plans to roughly 32 percent of the population of Indiana residents.  There are coverage options for people with pre-existing conditions, seniors, those people who are disabled, children, families and everyone in between.

Indiana Comprehensive Health Insurance Association (ICHIA)
This program was created to provide insurance to residents of Indiana who cannot obtain coverage in the open marketplace.  It operates as a safety net to catch the uninsured population of the state and offer health benefits to those who qualify.  If you qualify, you may have to pay between $145 and $1,687 for coverage benefits under this plan.
Pre-Existing Condition Insurance Plan (PCIP)
The PCIP covers people who are suffering from pre-existing conditions living in the state of Indiana.  If you haven’t had coverage for six months and have proof that you’ve been denied coverage because of the presence of a pre-existing condition, you may qualify for guaranteed coverage.

Medicaid is available to low income families and individuals who need assistance with full benefits.  Eligibility is based on your income level and you may have to pay some portion of the premiums to receive coverage.

Children’s Special Health Care Services (CSHCS)
CSHCS assists kids who are suffering from chronic health conditions.  People up to the age of 21 can get coverage under this plan as long as the income requirements are met and the individual is suffering from a chronic illness.

Hoosier Healthwise
This program offers medical services for women who are pregnant and children with three packages offered: Package A, Package B and Package C.  These packages depend on what you need and your individual situation and premiums can be anywhere from free to fifty dollars monthly.

Breast & Cervical Cancer Program (BCCP)
The BCCP is an insurance plan for women without benefits and offers a myriad of testing options related to breast and cervical cancer exams.  You can receive mammograms, breast exams, pelvic exams and more.  Coverage depends on your income level and no monthly costs are associated with this program.

Healthy Indiana Plan (HIP)
This program works to provide coverage to adults who don’t have any dependents.  If you aren’t able to get coverage under a group or individual plan, you can apply for HIP benefits if your income is between 22 and 200 percent of the Federal Poverty Level.

Medicare and the Medicare Prescription Drug Program
Coverage under Medicare is offered to end-stage renal disease sufferers, seniors over 65 and disabled people in the state of Indiana.  To qualify, you have to have worked in job that was covered under Medicaid for at least ten years.  Medicare consists of four parts: Part A, Part B, Part C and Part D and each offers different coverage options for those applying for Medicare benefits.

VA Medical Benefits Package
This program provides veterans with the ability to get guaranteed insurance coverage if they have completed their active duty requirement in any branch of the U.S. military.  As long as you have served 24 months consecutively in the military and haven’t been dishonorably discharged, you can enjoy a multitude of insurance options through this package.

Partnership for Prescription Assistance
The Partnership for Prescription Assistance offers around 475 programs that they connect consumers with to receive help with the costs of prescription medications.

Women, Infants, and Children (WIC)
The WIC program offers educational guidance to pregnant women and new mothers on infant care and breastfeeding options.  Infants are provided with shots and formula to encourage healthy growth while children under the age of five can get supplemental food items under this program.

National Association of Mental Illness (NAMI) Helpline
The NAMI helpline is a national program that staffs its organization with volunteers who have the latest resources on mental illness treatments and options.

HIPPA and Conversion Health Plans
HIPAA is the Health Insurance Portability and Accountability Act, which is a piece of legislation that offers protections for consumers with regard to how their medical information is used.  Your medical data should be protected and HIPAA seeks to create an environment where you don’t feel your data is ever compromised or used in an unauthorized manner.  Now that the Affordable Care Act has come into play, there are rules governing insurance providers.

Under HIPAA, insurance companies cannot deny group coverage to people with pre-existing conditions.  In addition, it has rules for the set amounts of time for exclusion and waiting periods, along with managing the premium amounts charged every month.

HIPAA has laid a lot of groundwork when it comes to insurance benefits, but it has yet to create mandatory insurance plans that are provided by employers.  However, there are options for continuing coverage after COBRA coverage is exhausted.