Note: This does not affect group/employer coverage or Medicare coverage.
Two of four insurers will no longer sell Obamacare plans in Indiana.
The two remaining carriers in the Indiana individual health insurance market for 2020 will be CareSource and Ambetter/MHS/Centene/Celtic. Both carriers will only offer limited access HMO plans with narrow networks of doctors and hospitals. Early intel shows that Ambetter will have an H.S.A. approved policy available, which is a big deal for clients who wish to leverage the H.S.A. tax advantages. In most situations, we will gravitate towards Ambetter as the recommendation for our clients who choose (or are forced to) stay on an individual ACA compliant plan for 2020.
CareSource has historically used a smaller network of providers and their complaint ratios with the Department of Insurance (DOI) are the highest on the DOI’s Complaint Index for 2020.
Anthem Indiana will only be offering off-exchange plans in Benton, Newton, White, Jasper and Warren counties. This does not affect group or medicare.
You can always sign up for free and use our plan finder to find every plan available in your area, on or off the exchange, as well as find what plans accept your doctors and hospitals, but you won’t be able to enroll till Nov 1st.
New Short Term Extended Options
As of October 2, 2019, customers will have the option to purchase short-term health policies for more than 12 months of coverage (up to 36 months) that will include the large Aetna PPO network and lower premiums than ACA plans.
There are some potential drawbacks of short-term health insurance:
- Short-term coverage may not offer any benefits for maternity, mental health, or any sort of pre-existing condition. If you suffer from some pre-existing conditions, you could be denied coverage, unlike with Obamacare.
ACA policies cannot decline applicants because of pre-existing conditions. Even with the federal government’s relaxed rules for short term coverage, most people should still consider these temporary policies as a temporary solution. It’s just that people in Indiana can rely upon them to access larger PPO networks at lower premiums for longer periods of time than they could in the past.
Short-term often are the best possible solution until the following year, when new Administration plans may be partially available. Although HSA-deposits are not allowed (plans are not considered HDHP), several higher-deductible options are offered.
Short-term plans do not provide “unlimited” benefits for as long as you have the policy. Usually, the maximum payout is between $250,000 and $2 million, which still should be enough for the limited amount of time you will keep the plan. Preventive benefits, unlike regular Marketplace policies, are not covered at 100% prior to the deductible, and often are not provided at all. Primary-care physician visits, prescriptions, and Urgent-Care visits are generally subject to a deductible, although a rider can often be added to remove the deductible.
Note: Many contracts provide a $50 copay for Urgent-Care visits. Telemed video consultations are also offered with many short-term plans. In 2020, most carriers allow COVID-19-related telemed visits to be covered with no out-of-pocket costs. Marketplace companies extended the free coverage to diagnosis and treatment.