Are you living in Indiana and struggling to get the right health insurance for yourself and your family? You aren’t alone. You might feel stuck, trying to choose between a plan you can afford but rarely use, and a comprehensive plan that is prohibitively expensive. But those aren’t your only options. Between the Health Insurance Marketplace, short-term options, health share plans, and more, there are ways to insure yourself against financially devastating health care costs. And we’re going to talk about them here in this article.
Major Medical Insurance in Indiana
By far, the number one option people have been flocking towards over the past several years is an ACA-approved health insurance policy from the Exchange. These plans became popular after The Patient Protection and Affordable Care Act (a.k.a. The ACA or “Obamacare”) was passed back in 2010. The legislation contains certain protections and provisions which help consumers like you get the best bang for their buck as far as their health insurance needs are concerned.
If you’re unfamiliar with the Exchange, it’s actually quite simple. Every year from November 1st to December 15th is Open Enrollment. During that time, you can fill out an application on HealthCare.gov to shop for plans and see if you qualify for a subsidy. The application is short, straightforward, and you usually receive a response online the same day you fill it out.
But why, exactly, are these major medical health insurance policies so popular compared to all the other options out there? You can narrow it down to a few different reasons: the guaranteed issue status, the guaranteed Essential Health and Wellness Benefits, and the savings for qualified applicants. For anyone who is unaware, guaranteed issue policies are those which must sell you coverage if you apply – they aren’t allowed to reject you because you represent a “high risk” investment based on pre-existing conditions. They also aren’t allowed to raise your premiums based on pre-existing conditions. In fact, the only factors which are allowed to play a part in determining your premium are:
- Tobacco use
- Family/Individual status
Then you have the guaranteed Essential Health and Wellness Benefits which come standard in each plan. When legislators were crafting Obamacare, they consulted health experts who agreed that providing these benefits for health insurance consumers was the most effective way to promote optimal health and wellness in a cost-effective manner over the long term:
- Ambulatory/outpatient services
- Emergency services
- maternity/newborn care
- Mental health and substance abuse
- Prescription drugs
- hab/rehab services and devices
- Lab tests
- Preventive and wellness services and chronic disease management
- Pediatrics (including oral and vision)
Unfortunately, providing all of these benefits for people can come with a monthly premium that’s more expensive than your typical car payment. That’s why the government has gone one step further and made generous subsidies available so that the average person and family can afford ACA insurance. Qualifying for a subsidy is primarily based on a combination of your income and your household size. In Indiana, the minimum income you must make to qualify for a subsidy is 138% of the federal poverty level. If you make above that (up to a maximum threshold of about 400% of the FPL) you can get your monthly insurance premiums subsidized and reduced by the government. If you make below that, there’s some good news: Indiana has chosen to accept federal funds which expand access to Medicaid for qualifying individuals and families.
|Household Size||Annual Income (138% of FPL)|
Applying for Medicaid in Indiana is simple: just go to the Indiana Medicaid website and fill out an online application, or contact your local office directly. But with Medicaid, qualifying is about more than just your income level. It’s a need-based program, so not all low-income individuals will be able to apply. The elderly, children, and the disabled tend to get priority status when it comes to Medicaid.
Short Term Health Insurance in Indiana
Unfortunately, not everyone will qualify for a subsidized ACA major medical policy. You might make too much money, or you may make too little income and not qualify for Medicaid. What happens if you fall into that gap? Many people in Indiana turn to short-term health insurance when this happens. And despite the shortcomings of these plans, there are some compelling reasons why.
The main selling point is that these plans can cost around 1/3 less compared to an unsubsidized major medical plan through the ACA. Many of these plans will allow you to customize the coverage and benefits you receive, but only to an extent. There aren’t any open enrollment periods with a short-term plan – you can sign up whenever you want. And you don’t have to apply through the ACA or fill out an application at HealthCare.gov, either. Lastly, there are consumer protections. If you ever happen to get into a dispute with your insurance provider over a claim, you don’t have to take it lying down. You will have some sort of legal recourse to get the money you are owed if they ever try to deny you your benefits for an unjust reason.
While those are all the good sides of short-term health insurance, there are some less-than-pleasant aspects you should know about before you sign up. Short-term health insurance plans do not have the guaranteed issue protections that ACA plans do. So even something as seemingly innocuous as your gender could count as a preexisting condition and either raise your rates substantially or make you ineligible for coverage. The coverage you get, no matter how hard you try to customize your plan, likely won’t have all of the 10 Essential Health and Wellness benefits which come with the ACA plans. You’ll also struggle with substantially high deductibles upwards of $5,000+, annual benefit limits, lifetime benefit limits, and no caps whatsoever on your own personal out-of-pocket costs. Despite all this, these plans can still be financially lifesaving if you happen to come down with some sort of catastrophic illness while you are insured under a short-term plan.
Christian Health Plans/Health Share Plans in Indiana
Can a Christian health plan be a good alternative to ACA insurance? Back during the days of the individual mandate, many consumers seemed to think so. Although these plans are not considered to be a legal equivalent to an ACA plan, the fact that they are religious in nature was enough to exempt many from the individual mandate when it was still law. But there is no longer a federal mandate, and the state of Indiana has no mandate either (although some states do), so the main reason to purchase a Christian health share plan is no longer a major concern for most people.
Christian health plans have a lot in common with short term health insurance, such as:
- No guaranteed issue
- Unlimited out-of-pocket costs
- Lifetime and annual benefit caps
- No guaranteed Essential Health Benefits
- Plans require a less costly “monthly share amount” than an unsubsidized ACA monthly premium
- Not considered to be a “real” health insurance plan by major organizations and care providers
However, the differences between the two are worth noting. For one, you won’t have the consumer protections with a health share plan that you do with short-term health insurance. This means that if you get unlucky and your Christian health plan decides not to make good on your promised benefits, you can’t take them to court in order to get the dispute resolved. As a member, you’ll most likely be asked to follow certain “participation guidelines” such as declaring a religious faith, ending any tobacco use, and pledging to adhere to a biblical lifestyle in general. But if you can’t find a more affordable option, then getting your health care managed under a health share plan might be a smarter alternative than going without any insurance whatsoever.
Fixed Indemnity Plans in Indiana
Whether you don’t currently have any coverage at all or whether your current coverage still has too many out-of-pocket costs, a fixed indemnity plan could help alleviate some of your financial burden. Just keep in mind that fixed indemnity plans do not count as an adequate replacement for ACA insurance. In fact, they are usually sold as a supplement to ACA plans in order to make your health care costs more manageable.
Fixed indemnity plans work by paying out a fixed amount (hence the name) of money every time you visit a doctor/hospital, every time you have a medically necessary event, or on a time-based incident (per day, per week, or per month). They have a few things in common with short-term health insurance, like the lifetime and annual benefit caps – as well as the medical underwriting which could subject you to higher rates based on preexisting conditions. While we recommend you consider an indemnity plan if you feel it might help supplement one of the other options we’ve discussed so far, we also feel the need to warn you that relying on fixed indemnity plans by themselves could still leave you with substantial out-of-pocket costs, a lack of adequate coverage benefits, or both.
Discount Cards in Indiana
Are you familiar with discount clubs like the AARP or AAA? Then you already have a good idea of how medical discount cards work. The majority of these programs address prescriptions only, but some include discounts for vision, dental care, or some routine doctor services. All you have to do is pay your membership fee (usually a monthly or annual sum) and wait for your card to arrive in the mail. Then, whenever you get care or purchase goods from a participating provider, you’ll get a discount right at the register.
Remember, though, that these cards are not major medical insurance, nor are they an adequate substitute for ACA coverage. You won’t be filing any claims or receiving any reimbursements for your care – you’ll just receive a small or moderate discount for the care you get. And you should make sure you do your research before you spend any hard-earned money on a discount card plan, especially if it sounds too good to be true. Not all medical discount card companies are created equal. Some will exaggerate the discounts available or lie about participating providers just to get your money. Thankfully, it’s not difficult to call ahead and check to make sure that the participating locations and providers the company advertises actually take the medical discount card you’re thinking about purchasing. And if you end up finding a good deal, medical discount cards can be a great way to save on your out-of-pocket costs.