Medicare in Louisiana

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Louisiana Medicare Plans

Medicare is a federal health insurance program designed especially for people of 65 years of age or older and for disabled people.

 

Run by the Centers of Medicare and Medicaid Services, the prime motive of this plan is to help people pay a certain portion of medical expenses. Medicare beneficiaries also pay a part of the medical expenses like deductibles, copayments and services that are not covered by Medicare. In Louisiana more than 856,000 Louisiana residents are enrolled in Medicare and one-third of Medicare beneficiaries are enrolled in Medicare Advantage plans.

Original Medicare

Original Medicare includes Medicare Part A and Part B where Part A helps in paying for inpatient care received in a hospital or skilled nursing facility along with some home health care and hospice care and Part B helps paying for doctors, medical services and supplies that are not usually covered under health insurance. Original Medicare is available for people of age 65 years or older, younger people with disabilities and people with End Stage Renal Disease. If you are enrolled in Original Medicare, then you directly get coverage from the federal government and have access to a nationwide network of healthcare providers. Original Medicare doesn’t include prescription drug coverage and if required you need to obtain separately through a stand-alone Medicare Part D prescription drug plan or you can enroll in a Medicare Advantage plan, which includes prescription drug coverage. If you have worked at least 10 years and paid Medicare taxes then you are not required to pay a premium for Part A coverage. However you need to pay premium for obtaining Part B coverage. If you do not have coverage through employer or other health coverage then you should enroll in Part B as soon as you become eligible otherwise you have to pay a late enrollment penalty for signing up later.

Medicare Part C or Medicare Advantage Plan in Louisiana

Medicare Advantage plan is available through private insurance companies approved by Medicare. If you enroll in Medicare Advantage plan then you have to opt out of Original Medicare, as this plan include all the benefits of Original Medicare along with other benefits like prescription drug coverage, vision care or dental services. Benefits may vary from plan to plan and rules associated with the plan can change every year. Medicare Part C plan is designed especially for beneficiaries who wish to expand their coverage beyond original Medicare. In Louisiana different health insurance companies offer Medicare Advantage plans in different parts, though plan specifics and costs may vary. Therefore, you should compare the costs and benefits of every Advantage plan to find coverage specifically as per your medical needs and budget. You should also make sure that the Medicare Advantage plan you choose include the prescription medications that you take. Open enrollment period for Medicare Advantage plan lasts from January 1 to March 31 every year and during this period you may switch between Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare. The common types of Medicare Advantage plans available in Louisiana include HMO plan, PPO plan and Private Fee for Service Plans.

Medicare Part D Plan in Louisiana

Medicare Part D plans provide prescription drug coverage for Medicare enrollees and it is an optional coverage that works with Original Medicare, Medicaid, employer health plans and in some cases even with Medicate Advantage plans. If you have Original Medicare then you can enroll in a stand-alone Medicare Part D Prescription Drug Plan to receive Medicare prescription drug benefits. Most of the Medicare beneficiaries in Louisiana have Medicare prescription drug coverage through Medicare Part D. Among the 844,000 Medicare beneficiaries in Louisiana there are nearly 635,000 beneficiaries have Part D coverage in Louisiana. In the state there are around 21 Medicare Prescription Drug Plans. If you want medicare benefits through a Medicare Advantage plan in Louisiana then you can sign up for a Medicare Advantage Prescription Drug Plan and if you have Original Medicare then you can enroll in a stand-alone Medicare Part D Prescription Drug Plan. Every Medicare Part D plan have its own set of benefits. The premium amount and the drugs covered in each Part D plan depends upon its formulary and tiers and some of the Part D plan also have in-network pharmacies that offer lower out-of-pocket drug costs.

Medigap in Louisiana

Medigap or Medicare Supplement plans help Medicare beneficiaries pay for out-of-pocket cost associated with Original Medicare like copayments, coinsurance and deductibles. There are ten standardized Medigap plans available in Louisiana. In order to enroll in Medigap in Louisiana you need to be enrolled in original Medicare. You should join Medigap plan during Medigap Open Enrollment Period that starts the day on which you turn 65 and get enrolled in Medicare Part B. You can join any Medigap plan available in your area with the insurance company of your choice. In this plan you cannot be denied coverage for pre-existing conditions. You should keep in mind that Medigap plans in Louisiana are meant to supplement the Original Medicare and not replace it.

Medicaid Plans in Louisiana

Medicaid program in Louisiana is a federally funded program offering health coverage within certain groups of the state. Medicaid plans provides complete package of medical coverage to individuals who qualify based on income and resource limit. Generally low income individuals, low income families with children, low income elderly and disable persons qualify for the Medicaid program. Mandatory Medicaid coverage include inpatient and outpatient hospital services, physician services,laboratory and x-ray services, long-term care facilities, early periodic screening services etc.

 

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