Medicare in Indiana: Plans and Coverage (2026)

Medicare in Indiana runs on federal rules, but the Indiana Department of Insurance helps provide free SHIP counseling and the state administers its Medicare Savings Programs through Indiana Medicaid. This guide covers Medicare in Indiana for 2026: every part, what each one costs, the plan choices available across the state, and the programs that reduce what you pay.1,2

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Indiana (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Indiana
• Help Paying for Medicare in Indiana
• Medicare Enrollment Periods
• Free Medicare Help: Indiana SHIP
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year, so check that CMS fact sheet or medicare.gov for the current year's figures.3 To talk through your own situation with a person, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048), staffed 24 hours a day, 7 days a week except some federal holidays.7 Indiana SHIP offers free one-on-one counseling for people with Medicare; its central office line is 1-800-452-4800.1

Original Medicare: Parts A and B

Original Medicare is the federal government's direct coverage program. Its mechanics and costs are the same in Indiana as in every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.3

The hospital deductible applies per benefit period, not per year. A benefit period begins on the day you're admitted and ends once you have gone 60 days in a row without inpatient hospital care or skilled care in a skilled nursing facility; a new admission after that gap starts a fresh deductible.3

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It does not cover routine dental, vision, or hearing.3,8

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)3
• Annual deductible: $283
• After the deductible: 20% of the Medicare-approved amount for most services

Part B is optional but nearly everyone enrolls. If you delay past your enrollment window without qualifying for a Special Enrollment Period or a Medicare Savings Program, you'll owe a permanent late penalty of 10% for each full 12-month period you could have had Part B but did not.9 If you are still working past 65 and covered by a current employer's group health plan, you can delay Part B without penalty and get an eight-month Special Enrollment Period counted from the month that job or the coverage ends, whichever comes first; COBRA and retiree coverage do not count as current-employer coverage, and if you are self-employed or your plan is not available to everyone at the company, ask your insurer whether it counts as employer group health plan coverage before you delay; if it does not, sign up at 65. This Special Enrollment Period does not apply if you are eligible for Medicare based on End-Stage Renal Disease (ESRD).10

Medicare Advantage in Indiana (Part C)

Medicare Advantage plans are offered by private insurers and bundle Part A and Part B coverage, with most also including Part D drug benefits. They must cover everything Original Medicare does, except hospice, which Original Medicare continues to cover separately. Most plans also offer extra benefits Original Medicare doesn't, such as routine dental, vision, hearing, and fitness.11

Plan availability in Indiana is not uniform. Indianapolis, Fort Wayne, and the other major metro areas generally have a wider selection of plans than rural parts of central and southern Indiana. The county you live in determines which plans are available to you, and the differences in networks, premiums, and benefits can be significant. Do not compare plans based on what a neighbor in a different county has; use the Medicare Plan Finder at medicare.gov and enter your own ZIP code.

How These Plans Work

• You continue paying your Part B premium ($202.90) in addition to any plan premium. CMS estimates the average Medicare Advantage plan premium is about $14 a month in 2026, and many plans charge $0 extra. Some plans go further and help pay all or part of your Part B premium.11,3
• Plans operate on networks (HMO or PPO). Verify that your doctors and hospitals are in-network before you enroll. Emergency care, out-of-area urgent care, and temporary out-of-area dialysis are covered whether you get them in the plan's network or outside it.11
• Plans typically require prior authorization for certain services, which Original Medicare generally does not.11
• Extras vary by plan, and not every plan includes them. Compare the dental, vision, and hearing benefits themselves rather than the fact that a plan lists them, and check what the dental benefit actually pays before you count on it for major work like a crown or dentures.
• Every plan caps your annual in-network out-of-pocket spending, federally limited to $9,250 in 2026; many plans set the cap lower. Original Medicare has no such cap on its own. CMS's sentence adds the condition: no yearly limit on what you pay out of pocket unless you have supplemental coverage, like Medigap, Medicaid, employer, retiree, or union coverage. What each covers varies by policy.11

You cannot use a Medigap policy alongside a Medicare Advantage plan, but that isn't a permanent lock-out. If this is your first Medicare Advantage plan and you aren't happy with it, federal law gives you a trial right to buy a Medigap policy and a separate drug plan as long as you return to Original Medicare within 12 months of joining; if you dropped a Medigap policy to join, you may be able to get that same policy back if the company still sells it, or another policy sold by an Indiana insurer if it doesn't. Wait past that window and in most cases you can't get the old policy back, and you may not be able to get any Medigap policy.11 If plan comparison feels complicated, an Indiana SHIP counselor can give you side-by-side policy comparisons at no charge.1

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare or bundled into a Medicare Advantage plan.4

The Inflation Reduction Act eliminated the old coverage gap as of 2025, so the donut hole is gone. Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).12
2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs for the rest of the year.4

The $2,100 cap is the most consequential change from prior years; it was $2,000 in 2025 and adjusts annually. The average standalone Part D premium for 2026 runs roughly $34.50 a month, though plan premiums vary widely.3 Every Part D and Medicare Advantage drug plan must offer the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs into capped monthly payments across the year instead of paying in full at the pharmacy.4 People who qualify for Extra Help typically pay much less.

Medigap in Indiana

Medigap policies are sold by private insurers to cover the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work with Original Medicare, and a Medigap policy can't pay a Medicare Advantage plan's copays, coinsurance, deductibles, or premiums.11

Indiana offers the federally standardized plans, labeled A-D, F, G, and K-N, regulated by the Indiana Department of Insurance. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the popular choice for people newly eligible; it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.13,6,3

Your first window is the federal Medigap Open Enrollment Period: six months beginning when you're 65 and enrolled in Part B. During it, an insurer must sell you any plan at the standard rate regardless of health.13 Outside that window, Indiana insurers may use medical underwriting for some purchases.

Indiana also has a Medigap birthday rule (HEA 1226, in effect since January 1, 2026, as amended by HEA 1260 for policies delivered, issued, or renewed on or after March 15, 2026): if you are age 65 or older and already enrolled in Medigap, you can move the same plan letter to a different carrier with no medical underwriting during a window that runs from one month before to one month after your birthday each year. The new policy starts on the first day of the month after you sign the application.5 Separately, Indiana law SEA 215 (effective January 1, 2025) created a guaranteed-issue window into Medigap for people who become eligible for Medicare while under age 65.5

Medigap or Medicare Advantage?

While you're in a Medicare Advantage plan it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. Medigap pairs with Original Medicare and gives you access to any provider who accepts Medicare nationwide, at a higher monthly premium. Medicare Advantage typically has lower upfront costs but limits you to a network. For a side-by-side look at the trade-off, see our guide to Original Medicare vs. Medicare Advantage.11

Help Paying for Medicare in Indiana

If you're on a fixed income, two programs can cut your Medicare costs substantially.

Medicare Savings Programs

Indiana administers the Medicare Savings Programs through Indiana Medicaid, with applications processed by the Division of Family Resources. The income limits the state's SHIP program publishes for 2026 run higher than the federal standard, so you may qualify even if your income is above the national figure.2

Indiana's limits sit well above the federal baseline: the federal QMB limit is $1,350 a month for an individual and $1,824 for a couple.2 Neither limit is measured against everything you have. SHIP's chart footnotes that "$65 plus half your income from active employment does NOT count toward total income," and that "some things you own do not count towards your asset limit, such as your home and furnishings, your car, burial plots, and at least $1,500 in life insurance."2 QMB is the most generous of the three: it can pay the Part B premium, the Part A premium if you owe one, the Part B and hospital deductibles, and copayments for services, and federal law bars providers from billing a QMB enrollee for that cost-sharing. SHIP footnotes that SLMB and QI only assist with Part B premiums.2 QI has to be applied for again every year, because being selected one year does not carry you into the next.2 For all three programs the 2026 asset limit is $9,950 for one person and $14,910 for a couple, and SHIP is blunt about what all of these figures are worth: "These limits are guidelines. The only way to know for sure if you are eligible is to apply."2

Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help with Part D.2 Here is how to apply in Indiana:

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024 the partial-subsidy tier is gone; everyone who qualifies now receives the full subsidy.14

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple, in the 48 contiguous states and DC (Alaska and Hawaii are higher)14
• Resource limits: $16,590 for an individual, $33,100 for a married couple, or $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses14
• If you already qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically2
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately2,14

Apply through Social Security at ssa.gov or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).15 Extra Help isn't available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, where residents apply through their local Medicaid office instead.14

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. These dates are federal and identical in Indiana and every other state.16

Changes made during Annual Open Enrollment take effect January 1. If you're already receiving Social Security benefits before age 65, you're enrolled in Parts A and B automatically; otherwise, sign up through the Social Security Administration.16

For a full breakdown of windows and late-penalty rules, see our guide to Medicare enrollment periods.

Free Medicare Help: Indiana SHIP

You don't have to work through this alone, and you don't have to pay a broker. The State Health Insurance Assistance Program (SHIP) is a free and impartial counseling program for people with Medicare, provided in Indiana by the federal Administration for Community Living and the Indiana Department of Insurance. SHIP is not affiliated with any insurance company or agency and does not sell insurance.1 Its volunteers complete an initial training and must not be employed by, or in a position to sell, any insurance product, agency, company or service.1

An Indiana SHIP counselor can help you:

• Analyze your insurance needs and compare policies side by side1
• Answer questions on Medicare, Medicare supplements, Medicaid, and help paying for prescriptions1
• Fill out applications for assistance, including low-income assistance applications1
• File claims and appeals1

Call SHIP's central office line at 1-800-452-4800.1 Trained SHIP volunteers assist through an 800 help line, virtually, or at local sites in most Indiana counties.1

Learn More

Find personalized help comparing your Medicare plan options in Indiana at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.