Introduction to Medicare Advantage Plan Indiana (Part C)

Not all seniors, especially those who are new to Medicare, are aware of the coverage gaps which exist in Parts A and B of the federal Medicare program. What you need to know is that without covering these gaps, you could end up paying thousands in out-of-pocket medical bills if you don’t protect yourself with a Medicare supplement insurance policy. There are several different types, but one of the more well-known policies is known as Medicare Advantage (or Medicare Part C). This is a private health insurance policy which, unlike most other supplements, replaces your Medicare benefits.

Federal Regulations for Medicare Advantage

Because a Medicare Advantage policy means you will no longer be receiving federal Medicare, the government has strict regulations in place to protect consumers from receiving inferior coverage. Your Advantage plan, by law, must provide coverage which is as good or better than what Medicare Parts A & B have to offer. Usually, the coverage is better. These plans are designed not just to replace Medicare, but to protect you from Medicare coverage gaps as well.

Medicare Advantage Enrollment In Indiana

Medicare Advantage has a noticeable presence in Indiana. Around 22% of Medicare-qualified seniors are currently enrolled in various Medicare Part C policies throughout the state. However, there is a wide variety of different Advantage plans available. The chart below breaks down the most common plans by popularity:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

Have you ever smoked? Are you a 65 year old senior who just enrolled in Medicare for the first time? Are you female, or male? The answers to these questions will play an important factor in how much you end up paying for a Medicare Advantage policy. For your reference, the chart below displays estimated rates for seniors in your area.

Most Popular Medicare Advantage Plans in Indiana

There are many different companies that may be willing to provide you with a Medicare Advantage policy. But once you choose one, your next important decision will be to choose the plan which gives you the best provider network. HMO plans have tighter restrictions, but are less expensive. PPO and other plans are more costly, but only because those networks will give you greater access to medical care.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

Your provider network will determine when, where, and how you get your medical care. Networks with more restrictions, like HMOs, have fewer doctors and hospitals for you to choose from. PPOs and PFFS networks, on the other hand, include a wider variety of doctors and facilities. Also, keep in mind that your insurance company can change the rules and restrictions on your provider network at any time. You should always be prepared for unexpected changes.

Doctor/Providers List

Drug, Vision and Dental Coverage

Traditional Medicare only concerns itself with basic health services, such as hospital visits and outpatient care. Only in recent years has the option for prescription drug coverage (offered by Medicare Part D) become available. Very few Medicare supplements, with the exception of Medicare Advantage, offer ancillary benefits such as vision or dental coverage. You can mix and match vision, dental, and prescription drugs all together on the same Advantage policy if you wish. But keep in mind that the more benefits you have, the more expensive the policy will be.

Enrollment Options & Best Time To Enroll

Unlike Traditional Medicare or certain Medicare supplement policies, Medicare Advantage providers Can take greater liberties when it comes to refusing to provide coverage for poor health or pre-existing conditions (such as End Stage Renal Disease). New Medicare recipients in relatively good health are the best candidates for receiving coverage. Contact your state department of insurance and/or your local insurance agent for more details on getting coverage with pre-existing conditions. You can also visit our Medicare Advantage Enrollment Pare for more info.

  • Initial Enrollment Period: The enrollment period during your first 6 months of being enrolled in Medicare.
  • Annual Enrollment Period (AEP): This timeframe runs from October 15th through December 7th every year, and during this time you can change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): Circumstances which happen outside of the AEP window, such as employer coverage loss or moving out of state, which may require you to find new coverage immediately.

What Medicare Advantage Plan Is Best For Me?

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