Talk with an Expert: 317-663-7602

 

Information on Indiana Medicare

When you reach the age of 65 it's important to know what your health insurance options are. Basically, all eligible residents will be enrolled in the government-sponsored Medicare program. However, like most other types of health care plans, you'll also have a choice when it comes to specific types of Indiana Medicare policies.

Three types of managed care Medicare plans that are available in certain Indiana counties are Cost Contract HMO (health maintenance organization), Medicare Advantage PPO (preferred provider organization), and Medicare Advantage PFFS (private fee for service).

It's always a good idea to know how the various Indiana Medicare plans differ regarding cost, rules and coverage. A Cost Contract HMO means that Medicare will reimburse the plan all of the covered medical services that you receive. You are asked to select a PCP (primary care provider) that works within the HMO's network of health care providers. If you receive treatment from a provider in this network you just have to pay the premium for the plan as well as any required copayment fees.

You can also receive treatment outside of the HMO's network and Medicare still pays the usual amount of the approved service, but you'll need to pay the Medicare co-payments and deductibles. You may enrol in a Cost Contract HMO if you aren't a member of Medicare Part A. However, you need to be enrolled in Medicare Part B and pay for it. If you have been diagnosed with end-stage kidney disease then the HMO doesn't have to accept you, the same goes if you're already in Medicare's hospice program.

With a Medicare Advantage PPO, there's a network of preferred health care providers, however you can receive treatment outside of the network for an additional fee. When you go outside of the network Medicare pays the same share as Original Medicare unless you require urgent or emergency care. You're responsible for Medicare coinsurance and deductibles, but you usually don't need to choose a PCP or get a referral to visit a non-network doctor. To be eligible for this type of health plan you need to be enrolled in Medicare Part A and B.

In a Medicare Advantage PFFS you're allowed to visit any health care provider who agrees to the terms of the plan. You need to reside in the service area of the pan though and Medicare will pay a specific amount each month to the plan for each member. Members are responsible for cost-sharing amounts and monthly premiums. PFFS plans provide the same coverage as Original Medicare does and usually offers extra benefits for a price.

To find out more about these Indiana Medicare plans feel free to call 317-663-7602 or visit www.healthinsurancemark.com. Our licensed, independent health insurance agency will be glad to assist you in all health insurance matters and will compare rates plans from several insurers to find the one that fulfils all of your needs. You can also take advantage of our online, free instant-quote engine on our website.