Note: This does not affect group/employer coverage or Medicare coverage.
For 2021, we have just three health insurance companies participating in the Indiana Individual Health Insurance market:
- CareSource Indiana Inc.
- Celtic Insurance company (MHS/Ambetter)
- Anthem Insurance Companies, Inc.
CareSource offered health insurance in all 92 Indiana counties in 2020 and will continue in 2021. They have requested an average rate increase of 4.30% for their 2021 plans. They will offer 3 Bronze, 6 Silver, & 2 Gold plans.
Celtic/ Ambetter- Will offer coverage in all 92 Indiana counties, and the average requested rate increase is 14.30%. They will offer 4 Bronze, 16 Silver, & 4 Gold plans on the exchange.
Ambetter is also going to offer off-exchange plans in 2021. This is worth noting as these plans may cost less than plans on the exchange. Off-exchange, they will offer 12 silver plans and 4 gold plans in all 92 Indiana counties.
Anthem is going to offer Indiana Individual Health Insurance plans in 8 counties, which is an expanded form 2020. Off-exchange, Anthem will offer a 1 catastrophic plan in Benton, Jasper, Newton, Warren, and White Counties.
On-exchange Anthem will offer 2 bronze, 1 silver, and 1 gold plan in Lake, LaPorte, and Porter counties. With estimated 700k residents of these three counties, this is Anthem's return to the individual exchange market. The cost of Anthem plans higher than CareSource and Ambetter, but depending on which anthem offers, this could be a solution. It would a surprise if Anthems offers their PPO network, but instead, their HMO network called Health Sync.
The overall average proposed rate increase for 2021 was 10.5 percent but average premiums in the state are still only slightly above average as of 2021.
Additionally, with the repeal of the tax penalty, Indiana residents will also be able to sign up for catastrophic health plans.
National General offers a year-long plan (the only one offered in Indiana) with access to Aetna's doctor's network, and is a great alternative to Ambetter or CareSource.
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.