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
- 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. 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. Delay past your enrollment window without other creditable coverage and you'll owe a permanent late penalty of 10% per every 12 months you could have had it.
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 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.
- Plans operate on networks (HMO or PPO). Verify that your doctors and hospitals are in-network before you enroll.
- Plans typically require prior authorization for certain services, which Original Medicare generally does not.
- 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.
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:
- Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
- Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
- 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 is about $46.50 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. Indiana has no state-specific switching rule or birthday rule beyond the federal standard. 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 strongest 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, meaning they can review your health history, charge more, or decline coverage.
Indiana follows the federal standard entirely; there is no state law here granting Medigap access to under-65 beneficiaries on Medicare through disability. If you're under 65 and on Medicare, insurers may decline or limit Medigap coverage until you reach 65 and your federal open-enrollment window opens.
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). Indiana uses the standard federal income tiers and resource limits, not higher state-set ones.
| Program | Federal name | Individual | Couple | What it pays |
|---|---|---|---|---|
| QMB | Qualified Medicare Beneficiary | Up to about $1,350 | Up to about $1,824 | Part A and B premiums, deductibles, coinsurance |
| SLMB | Specified Low-Income Medicare Beneficiary | Up to about $1,616 | Up to about $2,184 | Part B premium |
| QI | Qualifying Individual | Up to about $1,816 | Up to about $2,455 | Part B premium |
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 April.
Apply through Indiana Medicaid at the link above or get help from your local Indiana SHIP office. Enrolling in any of these programs automatically qualifies you for Extra Help with Part D.
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
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 is about $46.50), and many Medicare Advantage plans charge no extra premium. Your total depends on the plan you choose and the care you use.
No. Indiana follows the federal standard only. There is no state birthday rule or annual Medigap switching window. Your strongest opportunity to buy Medigap is the federal Open Enrollment Period: six months beginning when you're both 65 and enrolled in Part B. Outside it, insurers may use medical underwriting.
Indiana Medicaid, administered by the Family and Social Services Administration (FSSA), runs the three MSPs: QMB, SLMB, and QI. Indiana uses the standard federal income tiers and resource limits. You can apply directly through Indiana Medicaid or get help from an Indiana SHIP counselor.
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.
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.
Learn More
- Medicare: The National Guide
- Original Medicare vs. Medicare Advantage
- How Medigap Works
- Medicare Part D Drug Coverage
- Medicare Enrollment Periods
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.