The federal Health Insurance Marketplace holds an annual open enrollment period, usually from November through January. During this time, you can apply to buy health insurance coverage on the Marketplace and see if you qualify for financial assistance programs. Indiana also has health coverage called the Healthy Indiana Plan (HIP), and you can apply any time during the year. Both Marketplace and HIP coverage have eligibility requirements you must meet before you can get coverage.
Learn more about your options based on your current health coverage:
- I have health insurance through the federal Health Insurance Marketplace
- I have health coverage through the Healthy Indiana Plan (HIP)
- I do not have health coverage
- I have health coverage through my job or a family member’s job
You have health insurance through the Marketplace
If you have health insurance through the federal Health Insurance Marketplace, you will get a letter from the Marketplace requesting that you come back to the Marketplace during open enrollment and update your information. If you go back to the Marketplace to update your information, the Marketplace will reassess and confirm your eligibility. If the Marketplace thinks you may be eligible for HIP, it will forward your information to Indiana to determine your eligibility for Indiana Health Coverage Programs like the Healthy Indiana Plan.
If you have health insurance on the Marketplace and experience a life change at any time during the year, you may log in to your Marketplace account and select the option to “Report a Change.” Examples of life changes include a change in your household size, a change in your job or income, or a change in your home address. Once you report a change, the Marketplace will check to see if your eligibility has changed. Like during open enrollment, if the Marketplace thinks you may be eligible for HIP, it will forward your information to the state.
If you get a notice from the Indiana Family and Social Services Administration (FSSA) that says you are eligible for HIP, there are several actions you will need to take.
- Visit the Marketplace to end your coverage. Otherwise, you will receive bills for both your Marketplace plan and HIP, and you may have to repay some of the premium tax credits you used to lower the premium costs for your Marketplace plan. Once you have been determined eligible for HIP, you are not eligible for premium tax credits, starting on the first day of the next month.
- Click here for instructions on ending a Marketplace plan when you are approved for a state program like HIP.
- Choose your health plan. You will get information about your eligibility and may choose a health plan (Anthem, CareSource, MDWise or MHS) to manage your health care services. If one of these companies is providing your current Marketplace plan, it may also contact you directly about your eligibility for HIP.
- Make your POWER account contribution. You will receive a bill from your health plan for your monthly POWER account contribution. Paying this bill as soon as possible will guarantee you access to comprehensive coverage, without a gap in coverage.
You have health coverage through the Healthy Indiana Plan
If you are currently enrolled in the Healthy Indiana Plan (HIP), you will not be impacted by the federal Health Insurance Marketplace open enrollment period. However, if you think you may be eligible for the coverage on the Health Insurance Marketplace you should report a change to the Division of Family Resources one of three ways:
- Calling or faxing information to:
- 800-403-0864
- Mailing information to:
- PO Box 1810, Marion, IN 46952
- Submitting a change request through the FSSA Benefits portal:
If the Indiana Family and Social Services Administration (FSSA) determines that you are no longer eligible for HIP, your information will be forwarded to the Marketplace. You will get a denial notice from Indiana FSSA and should watch your mail for eligibility determination notices from the Marketplace.
You do not have any health coverage
If you do not have any health coverage, you can apply to either the Marketplace or HIP. Indiana has a HIP Eligibility and Contribution Calculator that asks you a few short questions about your estimated household income and size. Based on that information, the calculator tells you if you are likely eligible for HIP, or if you are more likely to be eligible for financial assistance on the Marketplace.
If you apply to the Marketplace or HIP and get a notice saying that you are not eligible for that program, your information will be sent automatically to the other program to see if you are eligible. You will not need to complete two separate applications, but you may need to provide some additional information.
You have health insurance through your job or a family member’s job
If you have health insurance through your job or a family member’s job, you will not be impacted by the federal Health Insurance Marketplace open enrollment period. The insurance you are getting may have its own open enrollment period and actions you need to take, so you should follow any enrollment instructions from your job or your family member’s job.
If you lose your job-based health insurance, you may be eligible for health coverage through the Marketplace or HIP. Indiana has a HIP Eligibility and Contribution Calculator that asks you a few short questions about your estimated household income and size. Based on that information, the calculator tells you if you are likely eligible for HIP, or if you are more likely to be eligible for financial assistance on the Marketplace.
If you apply to the Marketplace or HIP and get a notice saying that you are not eligible for that program, your information will be sent automatically to the other program to see if you are eligible. You will not need to complete two separate applications, but you may need to provide some additional information.