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Medicare Advantage Plans in Indiana

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What are Medicare Advantage plans?

If you’re eligible for Medicare, or you soon will be, you may be wondering about what Medicare plan options may be available to you in Indiana. You may find Medicare Advantage, also known as Medicare Part C, to be a workable option for you.

Original Medicare is a government-run health insurance program that consists of Part A (hospital insurance) and Part B (medical insurance). To be eligible for the program, you need to be an American citizen or permanent legal resident of at least five continuous years. You can qualify by age (65 or over), or qualify before age 65 by disability, or due to certain health conditions such as Lou Gehrig’s disease or end-stage renal disease.

Medicare Advantage plans are offered by private, Medicare-approved insurance companies and must include the same coverage for medical and hospital services as Original Medicare (except hospice care, which Medicare Part A covers). However, Medicare Advantage plans typically offer additional benefits, such as vision care, dental services, and prescription drug benefits.

Prescription drug coverage and Medicare Advantage plans in Indiana

Some Medicare Advantage plans in Indiana include prescription drug benefits, as they do in other states. These plans are referred to as Medicare Advantage Prescription Drug plans. Each of these plans has a list of covered prescription drugs, called a formulary. Formularies are divided into levels, called tiers, based on the medication costs; higher tiers tend to include more expensive prescription drugs. You may want to check the formularies of any plans you’re considering to make sure they include your medications. Plans sometimes change their formularies, however; you will receive notice from your plan when necessary.

Choosing a Medicare Advantage plan in Indiana

There are several types of Medicare Advantage plans, although not every plan may be offered in your part of Indiana. Some popular types are listed below.

  • Health Maintenance Organizations (HMOs) offer networks of providers for beneficiaries to choose from. Some HMOs don’t cover services provided outside the network.
  • Preferred Provider Organizations (PPOs) also offer provider networks, but usually let you go to providers outside the network. It typically costs less to visit providers inside the network.
  • Private Fee-for-Service (PFFS) plans often allow beneficiaries to see any provider that accepts Medicare and get specialized care without a referral, depending on the plan. PFFS plans set their own payment terms.

Beneficiaries that enroll in one of these plans are responsible for paying premiums, deductibles, and any other out-of-pocket costs associated with the plans. Those costs will vary from plan to plan, as will the type of coverage included. No matter which type of Medicare Advantage plan you may choose, you also need to continue paying your Medicare Part B premium. When you’re enrolled in Medicare Part C, you’re still in the Medicare program.

You may want to compare plans based on out-of-pocket costs, prescription drugs covered, and other benefits such as routine dental care to find a suitable plan for your needs. You can type your zip code into the form on this page to see a list of Medicare plans in your vicinity.

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