Health insurance is one of the many factors that contribute to good health. Having insurance gives you financial security if a medical emergency happens.
There are three main forms of health insurance when shopping outside of an employer health insurance plan: Medicaid, Medicare and Marketplace. Each offers different coverage options, and sometimes only certain people can apply for coverage.
Medicaid is a state health insurance program that is offered at little to no cost to low-income households. Household size, age and income are some of the things that can help determine the plan a person or family is enrolled in. There are many Medicaid plans in Indiana, including the Healthy Indiana Plan (HIP), Children’s Health Insurance Program (CHIP), Hoosier Healthwise and Hoosier Care Connect. The application for Medicaid is open year-round and is free.
Medicaid covers many medical services like hospital visits, wellness checkups, prescriptions, dental visits, behavioral health services and more.
Medicare is a federal health insurance program. Medicare is available for individuals that are 65 or older; for individuals under the age of 65 who have received Social Security Disability for 24 months; and for individuals with end stage renal disease. There are several parts to Medicare that cover different services like hospital care, prescriptions and visits with a medical provider.
There are many ways to enroll in Medicare.
- Automatic Enrollment is available for those who already receive Social Security benefits. A Medicare card is automatically sent three months before turning 65, and no enrollment application is needed.
- Initial Enrollment begins three months before the individual turns 65 and extends three months after turning 65.
- General Enrollment is available for individuals who did not enroll during their initial enrollment period. General Enrollment is annually from January 1 and ends on March 31 of each year. Your Medicare benefits will go into effect July 1st.
- Special Enrollment is available for those who continue to work past 65 and are covered by an employer health plan. Special enrollment is also available for the spouse of the person who holds the employer health plan. Individuals can enroll in Medicare Part A when they turn 65, and then will enroll in Medicare Part B when the employment health plan ends. If you move or your insurance company leaves Medicare you may also qualify for a Special Enrollment period.
Marketplace is a government website that offers health insurance plans. These plans are based on income and household size. Individuals can compare insurance plans and choose the one that works best for them.
Enrollment in Marketplace insurance is only available during the Open Enrollment period. Marketplace Open Enrollment begins on November 1 and goes through January 15. Individuals may apply for Marketplace plans outside of the Open Enrollment period only if they qualify for a Special Enrollment period.
The Special Enrollment period is available in certain situations.
- There is a change in household size, such as getting married, having a baby or getting a divorce.
- There is a change in residence, such as moving to a new county, moving to attend school, or moving to or from a shelter or other transitional living facility.
- Insurance coverage is lost due to the loss of an employer health insurance plan or similar situation. The Special Enrollment period is only available for 60 days after health coverage has ended.
Do you need help navigating health insurance?
HealthLinc offers health insurance enrollment assistance. Our enrollment navigators can help walk you through the application process and answer any questions you have. These services are open to both HealthLinc patients and non-HealthLinc patients and are no cost to you. Please call 888-580-1060 Ext. 4405 to schedule an appointment with one of our navigators.