Medicare in Indiana runs on federal rules, but the state adds free SHIP counseling and administers its Medicare Savings Programs through FSSA. 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.,

In This Guide

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or Indiana SHIP at 1-800-452-4800.

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.

Cost Amount
Monthly premium $0 for most people (40+ quarters of work history)
Hospital deductible $1,736 per benefit period
Hospital coinsurance, days 61-90 $434 per day
Lifetime reserve days $868 per day
SNF coinsurance, days 21-100 $217 per day

The hospital deductible applies per benefit period, not per year. A benefit period begins on the day you're admitted and ends 60 days after you leave; a new admission after that gap starts a fresh deductible.

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.

  • Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)
  • 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 other creditable coverage, you'll owe a permanent late penalty of 10% for each full 12-month period you could have had Part B but did not. 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 after that job or the coverage ends, whichever comes first; COBRA and retiree coverage do not count as current-employer coverage.

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.

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 cannot use a Medigap policy alongside a Medicare Advantage plan. If plan comparison feels complicated, an Indiana SHIP counselor will walk through it with you at no charge.

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.

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).
  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.

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 $40 to $50 a month, though plan premiums vary widely. 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. People who qualify for Extra Help typically pay much less.

Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.

Medigap in Indiana

Medigap policies are sold by private insurers to cover the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, not with Medicare Advantage.

Indiana offers the federally standardized plans, labeled A through 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.,

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. 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): 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. 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.

Medigap or Medicare Advantage?

You can't hold both. 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.

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 (FSSA), with applications handled by the Division of Family Resources (DFR). Unlike many states, Indiana sets its income limits higher than the federal standard, so you may qualify even if your income is above the national cutoff. It uses the standard federal resource (asset) limit.

Program Federal name Individual Couple What it pays
QMB Qualified Medicare Beneficiary Up to $2,015 Up to $2,725 Part A and B premiums, deductibles, coinsurance
SLMB Specified Low-Income Medicare Beneficiary Up to $2,281 Up to $3,086 Part B premium
QI Qualifying Individual Up to $2,481 Up to $3,356 Part B premium

Indiana's limits sit well above the federal baseline: for comparison, the standard federal QMB limit is about $1,350 a month for an individual and $1,824 for a couple. QMB is the most generous of the three: it covers your Part B premium plus your deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing. For all three programs the 2026 resource limit is $9,950 for one person and $14,910 for a couple. The income figures tie to the Federal Poverty Level and update each year.

Enrolling in any of these programs automatically qualifies you for Extra Help with Part D. Here is how to apply in Indiana:

1
Step 1

Gather your paperwork

Have your Medicare card and recent proof of income and assets ready, such as a Social Security award letter, pension or wage statements, and current bank balances.

2
Step 2

Apply through Indiana Medicaid

File your application with the Division of Family Resources through Indiana Medicaid's Medicare Savings Program page.

3
Step 3

Or let a counselor help

Call Indiana SHIP at 1-800-452-4800 and a counselor will help you complete the application and weigh your income against Indiana's higher limits, at no cost.

4
Step 4

Confirm this year's limits first

Because the thresholds rise each year with the Federal Poverty Level, verify the current figures before you file so you know whether you qualify.

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.

  • Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
  • Resource limits: $16,590 for an individual, $33,100 for a married couple
  • If you already qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically

Apply through Social Security at ssa.gov or call 1-800-772-1213.

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.

Period Dates What you can do
Initial Enrollment 7 months around your 65th birthday Sign up for Parts A, B, and D; pick MA or Medigap
Annual Open Enrollment Oct 15 - Dec 7 Switch MA plans, move between MA and Original Medicare, change Part D
MA Open Enrollment Jan 1 - Mar 31 Switch MA plans or drop MA for Original Medicare (if already in MA)
General Enrollment Jan 1 - Mar 31 Sign up for Part B if you missed your initial window
Medigap Open Enrollment 6 months from age 65 + Part B Buy any Medigap plan at the standard rate, no health screening

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.

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. Indiana runs the State Health Insurance Assistance Program (SHIP) through the Indiana Department of Insurance. SHIP counselors are trained, give free and unbiased help, and don't sell insurance.

An Indiana SHIP counselor can help you:

  • Understand what each part of Medicare covers and what you'll pay
  • Compare Medicare Advantage, Part D, and Medigap plans by ZIP code
  • Apply for the Medicare Savings Programs and Extra Help
  • Sort out claims, denials, and appeals

Call the statewide SHIP line at 1-800-452-4800 to reach counseling and get connected to local help.

Frequently Asked Questions

What does Medicare cost in Indiana in 2026?

Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the 2026 average runs roughly $40 to $50 a month), and many Medicare Advantage plans charge no extra premium. Your total depends on the plan you choose and the care you use.

Does Indiana have a birthday rule for Medigap?

Yes. Since January 1, 2026 (HEA 1226), Indiana has a birthday rule: 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 from one month before to one month after your birthday each year. It does not let you change plan letters or newly enroll. See our Indiana Medigap birthday rule guide for details.

Who runs the Medicare Savings Programs in Indiana?

Indiana Medicaid, administered by the Family and Social Services Administration (FSSA), runs the three MSPs: QMB, SLMB, and QI. Indiana uses higher, state-specific income limits than the federal standard, along with the standard federal resource limit. You can apply directly through Indiana Medicaid or get help from an Indiana SHIP counselor.

Who provides free Medicare counseling in Indiana?

The Indiana Department of Insurance runs SHIP, which gives free, one-on-one Medicare counseling through trained counselors who don't sell insurance. Call 1-800-452-4800 to reach the statewide line.

Is Medicare Advantage available across Indiana?

Medicare Advantage plans are available statewide, but the selection is wider in Indianapolis and other metro areas than in rural counties. Plan availability, networks, and costs differ by county. Use the Medicare Plan Finder at medicare.gov and enter your ZIP code to see what's actually offered in your area.

Your next step Call Indiana SHIP at 1-800-452-4800 for free, unbiased help comparing your Medicare Advantage, Part D, and Medigap options by ZIP code and applying for the programs that lower your costs. To compare plans yourself, use the Medicare Plan Finder at medicare.gov/plan-compare.

Learn More

MedicareMedicare Plans by State: What Varies and What Doesn'tOriginal Medicare is the same in all 50 states. Medicare Advantage, Part D, and Medigap rules are not. See what changes by state, then open your state guide. MedicareMedicare: The National GuideWhat is Medicare? A plain guide to Parts A, B, C, and D, who qualifies, 2026 costs, when to enroll, and what it doesn't cover, with help-paying options. MedicareOriginal Medicare vs. Medicare AdvantageCompare original Medicare vs Medicare Advantage on cost, networks, the $9,250 cap, and switching back. A neutral 2026 side-by-side to help you choose. MedicareHow Medigap WorksMedigap (Medicare Supplement) explained: how the standardized A-N plans work, Plan G vs Plan N, closed C and F plans, and the 6-month guaranteed-issue window. MedicareMedicare Part D Drug CoverageMedicare Part D in 2026: a $2,100 out-of-pocket cap, no donut hole, three benefit phases, the $615 deductible, premiums, the late penalty, and Extra Help. MedicareMedicare Enrollment PeriodsWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs.

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.

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