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Health care marketplace is now open in Indiana
e-Reports, Nov. 12, 2013
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Here are details and places to direct patients who ask for your help Untitled document

Computer glitches aside, the Affordable Care Act’s health care marketplace or exchange is now available to help uninsured Hoosiers shop for comprehensive health insurance coverage. In Indiana, four carriers are offering plans in our state’s federally facilitated exchange.

The Indiana Department of Insurance (IDOI) noted that of the top five carriers here, only Anthem is offering plans in the marketplace. The IDOI advised that the four carriers for our state’s federal marketplace are Anthem, Coordinated Care, MDWise and Physicians Health Plan of Northern Indiana. Find more details on the IDOI website here.

However, these four carriers don’t need to offer coverage all over the state. Geographic “rating areas” have been created – 17 in all – with only areas 2, 3 and 4 in the north and northeast part of the state having all four carriers participating. One area in the southeast has only one carrier offering plans.

Timeline for new coverage:
Oct. 1, 2013 Health insurance marketplaces open (sign-up begins
Jan. 1, 2014 Coverage under new plans begins
March 31, 2014 Last day to sign up for a plan 
(coverage begins May 1)

Health insurance marketplaces open(sign-up begins)Marketplace shoppers in Indiana will also choose from three different levels of coverage: bronze, silver and gold. The categories reflect varying percentages of the costs paid by patients in premiums, co-pays and deductibles, versus what the plan pays for services.

Other states have a fourth platinum level, but no plans are offering it in Indiana. Typically, the lower deductibles and co-pays are, the higher the monthly premiums. During the application process, shoppers will be screened to determine if they qualify for free or subsidized insurance.

Each health plan must cover these “essential health benefits”:

  • Emergency care
  • Ambulatory services
  • Hospitalization
  • Laboratory services
  • Maternity and newborn care
  • Pediatric care including oral and vision care
  • Mental health & substance abuse services
  • Prescription drug coverage
  • Some preventive and rehabilitative services

Assistance in your community
When patients come to you with questions and need to find resources, you can direct them to help close to home. Most community health centers have trained insurance navigators available; find one in your area here.

The main source of information, however, is the troubled federal website. There your patients are supposed to enter our state and find specific details about plans available to them.

If patients do not have access to a computer or need questions answered, they can talk to a representative 24/7 at (800) 318-2596 or for TTY, (855) 889-4325. Assistance is available in Spanish and some other languages.

Copyright: Information written and displayed on www.ismanet.org is the property of ISMA and may not be reproduced without expressed written permission of the Indiana State Medical Association.

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