If you live in Louisiana and are or soon will become eligible for Medicare, you may be wondering what your options are.
Medicare is a national government-sponsored health insurance program for people age 65 and over, as well as for people of any age who have certain health conditions.
There are several options available for residents of the Bayou State. Read on to learn more about Medicare in Louisiana.
Medicare is made up of different parts. Parts A and B come directly from the federal government and are considered original Medicare.
You can think of Part A as hospital insurance. It covers:
- inpatient care you receive when admitted to a hospital or skilled nursing facility
- some limited home health services
- hospice care
Most people don’t pay a premium for Part A. This is because it’s funded through a payroll tax that you’ve likely already paid during your working years.
Part B covers basic medical services and supplies that you get on an outpatient basis, such as when you see your primary doctor or a specialist.
You do pay a premium for Part B. Your premium is calculated based on factors such as your income and whether you receive certain types of disability assistance.
Original Medicare pays a portion of inpatient and outpatient healthcare costs, but not all of them. If you only have parts A and B, you’re responsible for paying a certain amount out of pocket when you see a doctor.
Plus, original Medicare doesn’t cover prescription drugs. To get drug coverage, you’ll need to enroll in Medicare Part D.
You can increase your coverage to help pay for copays, coinsurance, deductibles, and medication costs. For this purpose, the federal government has designated certain types of plans that can be purchased through private insurance companies. Medigap plans, also known as Medicare supplement plans, can help cover copays and deductibles.
For the most comprehensive coverage, you may want to consider a Medicare Advantage plan. Medicare Advantage (Part C) plans are full replacements for original Medicare. You can purchase them from a private insurance company.
Part C plans provide all the same coverage for hospital and doctor’s services as parts A and B. They also offer additional coverage, including for prescription drugs.
Medicare Advantage plans may also include coverage for dental, vision, and hearing, plus wellness and discount programs. And they typically offer significant savings on out-of-pocket costs you might pay if you have only original Medicare.
If you’re shopping for Medicare Advantage plans in Louisiana, you have a lot of options to choose from. Keep in mind, though, that not all plans are offered in all parishes. Here is a list of the companies that offer Medicare Advantage plans in Louisiana:
- Blue Cross Blue Shield of Louisiana
- Lasso Healthcare
- Peoples Health
- Vantage Health
Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
To be eligible for Medicare plans in Louisiana, you must fulfill at least one of the following requirements:
- be age 65 or older
- be of any age and have certain qualifying disabilities
- be of any age and have end stage renal disease (ESRD)
Your initial Medicare enrollment period begins 3 months before your 65th birthday and lasts for 3 months after it.
During this time, you can begin the enrollment process by filling out the online application available through the Social Security Administration. The application takes a matter of minutes to complete, and you can begin the process even if you’re not ready to retire.
You’ll need to initially enroll in Part A at a minimum. You may opt out of enrolling in Part B if you still qualify for group coverage through an employer. If you are still insured through an employer, you may qualify for a special enrollment period later on.
Part A is available without a premium for most people. Part B includes a premium.
You can enroll in Medicare Advantage plans in Louisiana during the yearly open enrollment period, which lasts from January 1 through March 31.
When choosing a Medicare plan, it’s important to think about your unique health needs. You may want to consider some of these questions:
- Do you need more coverage than what’s available through original Medicare? Depending on your health needs, adding on plans or choosing a Medicare Advantage plan may save you some money.
- What is the plan’s cost structure? How much are the premiums? How much can you expect to pay when you go to the doctor or need a prescription medication?
- What is the provider network like? Does it include doctors and hospitals near you or your preferred providers? What if you need care when you’re traveling?
- What is the satisfaction level of current or former members? You can often find reviews online. You may also want to consider asking family members, friends, or acquaintances who are Louisiana Medicare members what they think of their coverage.
- What type of plan is it? Will you need to choose a primary care physician or get referrals for specialty care? Some people prefer working with a trusted physician who oversees their care, such as with a Medicare Advantage Health Maintenance Organization (HMO). Other people would rather have the freedom to seek specialty care on their own, such as with a Preferred Provider Organization (PPO).
The following resources can help you learn more about Medicare plans and coverage options in Louisiana:
If you’re ready to get started enrolling in Medicare plans in Louisiana, here are some next steps:
- Do some research into Louisiana Medicare plans offered in your parish. You can use the list of plans above to get started, or reach out to an insurance agent in your area who sells Medicare plans.
- Fill out the online application available through the Social Security Administration. The application is quick and easy and doesn’t require you to submit any documentation right away.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.
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