Indiana Bill Could Expand Medigap Options for Medicare Beneficiaries

Indiana Medicare beneficiaries may soon have more flexibility when it comes to choosing and switching Medicare Supplement Insurance — commonly called Medigap — under legislation that has passed the Indiana House and is now headed to the Senate. The bill, sponsored by Representative Dant Chesser, is designed to create new options for residents enrolled in or considering Medicare Supplement plans. For the roughly 300,000 or more Hoosiers who rely on Medigap to cover costs that Original Medicare leaves behind, the outcome of this legislation could have real financial consequences.

To understand why this bill matters, it helps to know what Medicare Supplement Insurance actually does. Original Medicare — Parts A and B — covers a substantial share of hospital and outpatient costs, but it does not cover everything. In 2025, the Medicare Part A hospital deductible is $1,676 per benefit period, and the Part B deductible is $257 per year. Beyond those deductibles, beneficiaries are responsible for 20% of most outpatient costs with no out-of-pocket maximum. For someone managing a chronic condition or facing a major surgery, that 20% coinsurance can add up to tens of thousands of dollars. Medigap plans — sold by private insurers but standardized by the federal government — are designed to fill those gaps. Plans like Plan G, currently one of the most popular options for new enrollees, cover the Part A deductible, the 20% coinsurance, and most other cost-sharing, leaving beneficiaries with far more predictable expenses.

The challenge in Indiana, as in most states, is that Medigap access is not always guaranteed after your initial enrollment window. When you first enroll in Medicare Part B, you have a six-month open enrollment period during which insurers must sell you any Medigap plan they offer at standard rates, regardless of your health history. Miss that window, and you can face medical underwriting — meaning insurers can review your health history and either charge you significantly more or deny you coverage altogether. A 70-year-old with diabetes, heart disease, or a history of cancer may find it nearly impossible to switch Medigap plans in states without additional protections. This is the core problem that legislation like Rep. Chesser's bill aims to address.

Thirteen states have enacted what is known as a birthday rule, which gives Medigap enrollees a 30-day window around their birthday each year to switch to a plan with equal or lesser benefits without medical underwriting. Those states include California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, and Oregon. Indiana is not currently among them. That means most Indiana residents who enrolled in a Medigap plan years ago — perhaps when premiums were lower or their health was better — are effectively locked into that plan. If their insurer raises premiums substantially, they may have no practical way to shop for a better rate without risking denial based on their current health status. The Chesser bill, if it becomes law, could change that dynamic for Indiana residents.

The financial stakes of Medigap access are not abstract. Monthly premiums for Medigap Plan G in Indiana can range from roughly $100 to over $250 per month depending on age, gender, tobacco use, and the insurer — a spread of more than $1,800 per year for identical coverage. Beneficiaries who enrolled with one carrier a decade ago and have since seen their premiums climb may be paying significantly more than a new enrollee would pay with a competitor. Without guaranteed issue protections or a birthday rule, those beneficiaries have limited recourse. Legislation that creates new switching options could allow long-term Medigap enrollees to shop competitively and potentially reduce their annual premium burden by hundreds or even thousands of dollars.

It is worth noting that not all Medigap plans are created equal, and any new enrollment flexibility would require careful navigation. Plan F, which covered both the Part A and Part B deductibles, was phased out for new Medicare enrollees as of January 1, 2020 — though those already enrolled in Plan F before that date can keep it. New enrollees today typically choose between Plan G, which covers nearly everything except the Part B deductible, and Plan N, which has lower premiums but requires copayments of up to $20 for office visits and up to $50 for emergency room visits. If Indiana's legislation allows beneficiaries to switch plans more freely, understanding the differences between plan types will be essential to avoid inadvertently reducing coverage while chasing a lower premium.

Indiana beneficiaries who want to track this legislation or understand how it might affect their current coverage have several resources available. The Indiana Department of Insurance, which oversees Medigap regulation in the state, can be reached at www.in.gov/idoi. The State Health Insurance Assistance Program (SHIP) — known in Indiana as the Indiana SHIP — provides free, unbiased counseling to Medicare beneficiaries and can help you evaluate your current Medigap plan against alternatives. Reaching an Indiana SHIP counselor through the Indiana Family and Social Services Administration is a practical first step for anyone uncertain about whether their current plan still makes sense.

For beneficiaries who are not yet enrolled in Medigap, or who are approaching their initial Medicare enrollment, the timing of this legislation is worth watching. If the Senate passes the bill and it is signed into law, new protections could take effect that make it easier to course-correct after your initial enrollment decision. That said, the best financial protection remains enrolling in a Medigap plan during your guaranteed issue window — the six months following your Part B effective date — when you have the strongest legal right to coverage regardless of health status. Waiting to see what the legislature does before enrolling is a gamble that could cost you your guaranteed issue rights permanently.

Finally, it is important to remember that Medigap plans do not include prescription drug coverage. Beneficiaries who choose Medigap over Medicare Advantage will need a separate Part D prescription drug plan, with 2025 premiums averaging around $46 per month nationally, though Indiana plan options and premiums vary. The Annual Enrollment Period — October 15 through December 7 — is the primary window to enroll in or switch Part D plans each year. Keeping both pieces of the coverage puzzle in mind is essential for anyone evaluating their Medicare Supplement options as Indiana's legislative process unfolds.