Indiana Health Insurance Consumer Guide

You can buy individual and family health insurance from Indiana’s Marketplace if:⁵

• You live in Indiana. 
• You are lawfully present in the U.S.
• You don’t have Medicare.
• You are not incarcerated.

Marketplace financial assistance, such as premium subsidies and cost-sharing reductions, depends on your income and how it compares with the cost of the second-lowest-priced Silver plan where you live. This cost is based on your age and location. 

In addition, to qualify for financial assistance, you must meet the following: 

• Not have access to affordable coverage through your employer. Our Employer Health Plan Affordability Calculator can help you check if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP

In Indiana, you can sign up for individual and family health plans that comply with the ACA during the annual open enrollment period.⁶ This period runs from November 1 to January 15.

If you sign up before December 15, your coverage starts on January 1. If you enroll between December 16 and January 15, your coverage begins on February 1.

If the open enrollment deadline passes, you may still be able to sign up for or make changes to an ACA Marketplace health plan through a special enrollment period (SEP). To qualify for a SEP, you’ll need a qualifying life event.

However, you can apply in some situations even if you don’t have a qualifying life event. These include:

• If you’re qualified for premium tax credits and your income is less than 150% of the poverty level, you can enroll at any time until at least 2025.⁷
• If you’re a Native American, you can enroll whenever necessary.⁸

If you lose Medicaid or CHIP between March 31, 2023 and July 31, 2024, you can use the extended SEP to enroll year-round.⁹

There are a few ways to enroll in an exchange health plan in Indiana:

1. You can sign up on HealthCare.gov – the ACA exchange website.
2. Alternatively, you can call them at (800) 318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.
3. If you also get help from agents, navigators, certified application counselors or an approved enhanced direct enrollment entity.¹⁰

Many people, such as early retirees who aren’t on Medicare yet, self-employed individuals, and those working for small businesses without health benefits, find the ACA Marketplace helpful.

In Indiana, you can find affordable health plans through the ACA Marketplace’s website: HeathCare.gov.

Thanks to the ACA, you may be eligible for income-based subsidies called Advance Premium Tax Credits (APTC), which help reduce your monthly premiums.

Nearly nine out of 10 Indiana exchange enrollees were eligible for subsidies on 2023 plans, with an average monthly savings of about $455. People who received these subsidies pay an average monthly premium of $125.¹¹

Source: CMS.gov¹²

Cost-sharing reduction also decrease costs by helping lower your deductibles and out-of-pocket costs, and you may qualify if your income is lower than 250% of the federal poverty level.¹³

Indiana is one of only two states that takes a unique approach to cost-sharing reductions (CSR) by distributing them across plans at all metal levels (broad loading).¹⁴ This differs from the standard practice of adding CSRs to Silver plan rates (Silver loading).

Medicaid is another affordable health coverage for those who meet the criteria. Check out our guide on Medicaid in Indiana for more information.

Short-term plans are also available as a cost-effective option if you don’t qualify for employer plans, Medicaid, Medicare, or subsidies from the exchange.

Five insurance companies provide individual and family plans through the exchange in Indiana.¹⁵ 

• Anthem (Anthem BCBS)
• Caresource
• Celtic/MHS/Ambetter
• Cigna (added for 2023)
• US Health and Life Insurance Company

For 2024, Aetna Health also will offer coverage through the Indiana exchange, increasing the number of participating insurers to six.¹⁶

Indiana individual market insurers have proposed the following average rate increases for 2024:¹⁵

Source: HealthCare.gov¹⁵ 

Rate increases apply to the full-price premiums. But, in Indiana, most people who use the exchange in 2023 receive financial assistance through premium tax credits.¹¹ 

If you qualify for subsidies, the actual change in what you pay depends on how much your plan’s cost changes and how much financial assistance you receive from the government.

During the 2023 enrollment period, 185,354 people signed up for private individual market plans using the Indiana exchange.¹¹ This marked the highest enrollment since 2016.

Source: 2014,¹⁷ 2015, ¹⁸ 2016,¹⁹ 2017,²⁰ 2018,²¹ 2019,²² 2020,²³ 2021,²⁴ 2022,²⁵ 2023,²⁶ 2024²⁷

HealthCare.gov
800-318-2596

Indiana Department of Insurance
Oversees and licenses health insurance companies, brokers, and agents who sell insurance plans. It can be a valuable source for Indiana residents with questions or complaints about their health coverage.

Affiliated Service Providers of Indiana, Inc. (ASPIN)
A Navigator organization funded by the federal government, serving Indiana. They can assist with questions and help people enroll in Medicaid or a private insurance plan through the exchange.

Indiana State Health Insurance Assistance Information Program (SHIP)
This local service offers guidance and information to Medicare beneficiaries and their caregivers.