Indiana Health Insurance Consumer Guide

You can buy individual/family health insurance from Indiana’s Marketplace if:⁶

• 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 household income. In addition, to qualify for financial assistance, you must: 

• Not have access to affordable coverage via an 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/Hoosier Healthwise.
• Not be eligible for premium-free Medicare Part A. ⁷
• File a joint tax return with your spouse, if you’re married.⁸ (with very limited exceptions)⁹
• Not be able to be claimed by someone else as a tax dependent.⁸

In Indiana, you can sign up for ACA-compliant individual and family health plans during the annual open enrollment period, which runs from November 1 through January 15.¹⁰ 

If you sign up by 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 generally 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 eligible for premium tax credits and your income is no more than 150% of the poverty level, you can enroll at any time.¹¹ (The federal government has proposed making this a permanent SEP opportunity.)¹²
• If you’re a Native American, you can enroll anytime.¹³
• If you lose Medicaid or CHIP between March 31, 2023 and November 30, 2024, you can use the extended SEP to enroll at any time during that window.¹⁴

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. You can get help — in person, online, or over the phone, from agents, navigators, or certified application counselors.
4. You can enroll via an approved enhanced direct enrollment entity.¹⁵

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 premium subsidies called Advance Premium Tax Credits (APTC), which help reduce your monthly premiums.

Nearly nine out of 10 Indiana exchange enrollees were eligible for premium subsidies on 2024 plans, with an average monthly savings of about $452. People who receive these subsidies pay an average monthly premium of only $82, after the subsidies are applied.¹⁶

Source: CMS.gov¹⁷

Cost-sharing reductions (CSR) also reduce costs by helping lower your deductibles and out-of-pocket costs. CSR benefits are automatically built into all of the available Silver-level plans as long as your income isn’t more than 250% of the federal poverty level.⁴

The federal government used to reimburse insurers for the cost of providing CSR benefits, but that ended in 2017. Since then, insurers have been adding the cost of CSR to the premiums they charge. In most states, this cost is only added to Silver-plan rates, since CSR benefits are only available on Silver plans. But Indiana is one of only two states where insurers are required to spread the cost of CSR across premiums for plans at all metal levels (broad loading, as opposed to the silver loading approach taken in most states).¹⁸

Medicaid offers very affordable access to coverage and care for those who meet the eligibility 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. Learn more about short-term health insurance in Indiana.

Six insurance companies provide individual and family plans for 2024 through the exchange in Indiana,¹⁹ including Aetna Health, which is new to Indiana’s Health Insurance Marketplace.²⁰

For 2025, there will continue to be six insurers, but with some changes:²

• UnitedHealthcare Insurance Company is joining the market in Indiana, and will offer plans plans through the Marketplace.
• Celtic will no longer offer on-exchange plans, and will instead only offer plans outside the exchange. Everyone with an on-exchange Celtic plan in 2024 will be mapped to a Coordinated Care plan (Coordinated Care and Celtic are both owned by the same parent company, Centene²¹)
• U.S. Health & Life is exiting the individual market in Indiana at the end of 2024.

For 2025, Indiana’s Marketplace insurers will implement the following average rate changes, which amount to a weighted average rate decrease of 1.3%.²  

Source: Indiana Department of Insurance²

The average rate changes apply to the full-price premiums. But most Indiana residents who use the exchange receive financial assistance in the form of premium tax credits (premium subsidies), and thus do not pay full price.¹⁷

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.

For perspective, here’s an overview of how full-price premiums have changed over the years in Indiana’s individual/family health insurance market:

• 2015: Average increase of 5%.²²
• 2016: Average increase of 0.7%.²³
• 2017: Average increase of 18.9%.²⁴
• 2018: Average increase of 24%.²⁵
• 2019: Average increase of 2.6%.²⁶
• 2020: Average increase of 13.5%.²⁷
• 2021: Average increase of 10.5%.²⁸
• 2022: Average decrease of 1.7%.²⁹
• 2023: Average increase of 5.7%.³⁰
• 2024: Average increase of 2.1%.³¹

During the open enrollment period for 2024 coverage, 295,772 people enrolled in private individual market health plans through the Indiana Marketplace.³²

The 2024 enrollment number was a record high (see chart below for historical enrollment numbers).

Enrollment has been growing since 2021, partly due to the subsidy enhancements created by the American Rescue Plan and Inflation Reduction Act.

The enrollment growth in 2024 was also due to the “unwinding” of the pandemic-era Medicaid continuous coverage. As of June 2024, more than 479,000 Indiana residents had been disenrolled from Medicaid.³³ And CMS reported that by April 2024, more than 125,000 of those people had transitioned to a Marketplace plan.³⁴

Source: 2014,³⁵ 2015,³⁶ 2016,³⁷ 2017,³⁸ 2018,³⁹ 2019,⁴⁰ 2020,⁴¹ 2021,⁴² 2022,⁴³ 2023,⁴⁴ 2024⁴⁵

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.