Health Care Benefits: Indiana

Federal law and guidance on this subject should be reviewed together with this section.

Authors: Stuart R. Buttrick and Tareen Zafrullah, Faegre Drinker Biddle & Reath LLP

Summary

• Indiana chose not to establish a state-based Marketplace under the Affordable Care Act. See Health Insurance Marketplaces Under the ACA.
• Same-sex marriage is legal nationwide. See Same-Sex Partner Benefits.
• Small employers in Indiana (2-50 employees) are eligible to purchase small group policies and may be eligible for a new program permitting small employer pooling to achieve a more affordable group rating. See Health Coverage for Small Employers.
• Group health policies must provide parity in the coverage provided for mental health and substance abuse. See Mental Health Parity and Substance Abuse Coverage.
• Group health policies must provide coverage for certain dependents. If a group health plan provides maternity coverage, it must also cover postpartum stays and certain newborn exams and testing. See Maternity and Dependent Coverage.
• Health insurance policies that provide coverage for a mastectomy must provide coverage for reconstructive breast surgery and prosthesis. See Reconstructive Breast Surgery.
• Health insurance policies must provide coverage for certain other illnesses, diseases and medical and surgical procedures. See Breast Cancer Screening Mammography; Prostate Cancer Screening; Colorectal Cancer Screening; Diabetes and Inherited Metabolic Diseases; Treatment of Morbid Obesity; Treatment of Pervasive Developmental Disorders; Orthotic and Prosthetic Devices Coverage; Coverage of Dental Anesthesia and Hospitalization.
• Health insurance policies that cover prescription drugs must also cover certain other cancer drugs, certain routine costs for clinical trials and off-label uses of a drug in some cases. See Coverage of Certain Drugs.
• Insurers are prohibited from discriminating against individuals for certain reasons. See Prohibition in Insurer Discrimination.