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Indiana Health Insurance
Having a suitable health insurance has always been a priority when it comes to protecting your family against unexpected events. Purchasing health coverage is costly which needs a thorough review of all future risks and its influence on your financial health. In the U.S., nearly 47 million people are uninsured, majority of whom are working families who are exposed to probability of huge medical bills due to lack of proper health coverage. For those families who are not covered by their employers’ group plan, there are low-cost state sponsored health insurance programs that provide insurance to the medically-uninsurable individuals.
In 2008, Indiana stood on the 34rd spot on the Healthiest States List as issued by the United Health Foundation. The state was on 33rd and 32nd position in 2006 and 2007 respectively. Many factors that have contributed to the low ranking include increase in the percentage of children poverty and the weak public health funding. The state of Indiana, with more than a six million population, offers both private-market and public health insurance alternatives. The private-market health insurance consists of various types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide economical health coverage to the uninsurable citizens of Indiana who meet specific eligibility requirements of age and income.
The Indiana Department of Insurance manages and administers all kinds of insurance sold through private-market health insurers as well as public health coverage programs. However, approximately 11.6% of the state population is still uninsured. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, roughly 34.8% of uninsured residents come under the above 200% FPL category.
On the whole, Indiana’s Healthcare System is striving to provide proper health care to its residents. If you are an Indiana resident in need of suitable health coverage, contact a licensed health insurance agent/broker to the avail the suitable health insurance options and their benefits.
Individual/Family Health Insurance
Below is the guidelines for applying for and obtaining individual health insurance in the state of Indiana. These regulations apply to all insurance companies offering individual or family health insurance in Indiana:
| Medical Underwriting | Yes |
Pre-Existing Condition Exclusion Period | 12 months |
Look Back Period | 12 months |
Look Back Standard | Prudent person |
Mandatory Benefits | Cancer screening for women including breast cancer screening, reconstructive surgery after mastectomy, OB/GYNs are Primary Care Providers |
Market Rate Restrictions | None |
Guaranteed Issue Options | None |
Small Group Health Insurance
Below is the guidelines for small group health insurance in the state of Indiana. These regulations apply to all insurance companies offering small group health insurance in Indiana:
| Small Group Size | 2-50 |
Employee Qualifications | Owner can count as an employee |
Guaranteed Issue | Yes |
Premium Rating Factors | Rate Bands |
Rate Adjustment Factors | 35% |
Look-Back Period | 6 months |
Pre-existing condition exclusionary period | 9 months |
Mandatory Benefits | Same as individual |
State Cobra Variations for Small Groups
Below are the COBRA guidelines for small groups in the state of Indiana. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:
| Mini-Cobra Option | No |
Eligible Group Sizes | NA |
Extension of Benefits Period - Standard | NA |
Extension of Benefits Period - Disabled | NA |
Maximum Premium Increase | NA |
State Legislation Reference | NA |
Additional Notes | NA |
State Sponsored Health Insurance Programs
There are several state sponsored health insurance programs in the State of Indiana to assist those without insurance in obtaining adequate coverage.
High-Risk Pools
Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of Indiana is summarized in the chart below:
| Plan Name | Indiana Comprehensive Health Insurance Association (ICHIA) |
Website | |
Phone Number | 800-552-7921, 317-614-2133 |
HIPPA Eligibility Required? | Yes |
Available Carriers | Blue Cross Blue Shield Provider Access |
Pre-Existing Condition Waiting Period | 3 months |
Enrollment Periods | Open to New Enrollment |
Premium Limits | No more than 150% of standard rate |
Lifetime Maximum Benefit | Not Specified |
Special Notes |
|
Children’s Health Insurance Program
Through shared funding from the federal government, the State of Indiana provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:
| Program Name | Hoosier Healthwise |
Website | |
Phone Number | 800-889-9949 |
Apply Online | Yes |
Age Limits | Under 19 |
Insurance Carrier | Anthem, Managed Health Services and MDwise |
Length of Coverage | 12 months |
Residency Requirements | Indiana resident and U.S. citizen, legal immigrant |
Other Eligibility Requirements |
|
Pre-Existing Condition Exclusions | No |
Cost | Premiums range between $22 and $50 per month, based on family income and the number of family members covered. |
Medicaid
Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of Indiana:
| Governing Agency | Indiana Family and Social Services Administration |
Website | |
Phone Number | 800-457-4584 |
Residency Requirements | Indiana resident and U.S. citizen, documented immigrant |
Federal Poverty Line Income Limits | Under 100% FPL with assets less than $3K for one person (after car, house, clothing), and Parents of children living in household |
Additional Resources
Indiana Health Care Options Matrix™ Guide
Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines Indiana’s public and private health care choices for individuals and groups with various demographic profiles.
Family Health Insurance Guide by HealthInsuranceFinders.com
The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.
Indiana: At-A-Glance
Provides all-inclusive health data of Indiana. Statehealthfacts.org is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.
