Medicare Advantage Plans in Louisiana

In addition to the best jazz, parties and creole food found just about anywhere, Louisiana also has more Medicare Advantage plans than most states. Read on to learn about Medicare Advantage in Louisiana and how you can benefit from this option.

In 2022, Louisiana had 102 Medicare Advantage plans available in various parts of the state (not every plan is available in every county) — more than many states provide. But what exactly is Medicare Advantage, and how does it differ from Original Medicare?

Medicare Advantage plans are also known as Medicare Part C. It’s a type of Medicare plan offered by private insurance companies. The providers that offer Part C are approved by Medicare and are required by law to follow specific rules and guidelines.

Medicare Advantage plans must cover everything that Parts A and B of Original Medicare does.

With a Medicare Advantage plan, you have coverage for inpatient services received in facilities such as hospitals, skilled nursing facilities and hospice care facilities.

Medicare Advantage also provides coverage for outpatient services such as primary care doctor and specialist visits, laboratory tests, clinical trials, preventive care and durable medical equipment.

Medicare Advantage plans also cover healthcare services and benefits that Original Medicare doesn’t, including Part D prescription drug coverage (people with Original Medicare must purchase a separate Part D plan for coverage). If your Medicare Advantage plan covers prescription drugs, you don’t need to purchase additional coverage for medications.

Part C coverage often includes these extras you won’t find with Original Medicare:

• Vision care
• Dental care
• Hearing care, including hearing aids
• Health and wellness programs such as free SilverSneakers gym memberships
• Transportation
• Over-the-counter items

• In Louisiana, the average monthly premium cost for a Medicare Advantage plan in 2023 was $14.53. However, no matter where you live in the state, you have access to at least one Medicare Advantage plan with a $0 monthly premium.
• The Medicare Part B monthly premium also applies. Most Medicare beneficiaries in Louisiana paid the standard Part B premium of $164.90 in 2023.
• Other costs you may incur include deductibles, copays and coinsurance. These vary by plan and are often determined by your choice of using in-network or out-of-network plan providers.

Louisianans who are eligible for Original Medicare are also eligible for Medicare Advantage.

Most people in Louisiana become eligible for Medicare when they turn 65.

To be eligible for Medicare, you must be a U.S. citizen or permanent legal resident who has lived in the U.S. for at least five consecutive years. In addition, you must meet one of these requirements:

• You’re 65 years old or older.
• You have a qualifying chronic disability.
• You have Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig’s disease).
• You have end-stage renal disease (ESRD).

If you have a disability, you can get a Medicare Advantage plan in Louisiana at any age, if you meet one of these requirements:

• You’ve received disability benefits from Social Security for at least 24 months (An exception to the 24-month rule is made for people with ALS. If you have ALS, you can start receiving Medicare the first month you get disability benefits).
• If you have ESRD, you can get Medicare provided you’re on dialysis, or are a kidney transplant patient. You may begin coverage the first day of the fourth month you start getting dialysis.

There are several signup times for Medicare Advantage in Louisiana:

Initial Enrollment Period – If you’re Medicare-eligible due to age, initial enrollment starts three months before your 65th birthday and ends three months afterwards, for a total of seven months.

Medicare Open Enrollment Period – Also known as the Annual Enrollment Period, you can join, switch or drop a plan in Louisiana from October 15–December 7 each year.

Medicare Advantage Open Enrollment Period – If you’re already enrolled in Medicare Advantage, you can switch to a Medicare Advantage plan or to Original Medicare from January 1 to March 31 each year. However, if you have Original Medicare, you can’t switch Medicare Advantage during this period.

Special Enrollment Period – Special enrollment periods are triggered by personal events specific to you that affect your health insurance. These include losing your current health insurance or moving to a new location that is not in your current plan’s coverage area.

There are many Medicare Advantage plans offered throughout Louisiana that include Part D prescription drug coverage.

Each plan is based upon a formulary. This formulary lets you know what medications will be covered, and how much they will cost. Formularies feature tiers made up of generic, brand name and specialty drugs. Every drug plan must, by law, include one or more drugs that are commonly prescribed for conditions like arthritis, asthma, heart disease, thyroid disease and cancer.

Some Medicare Advantage plans in Louisiana have a $0 monthly premium for prescription drug coverage. Some also have a $0 annual drug deductible. However, in some instances you may decide that a more expensive plan will provide more coverage and better savings in the long run. This may be determined by the medications you need to control a specific condition.

A GoHealth licensed insurance agent will be happy to guide you through each plan’s fine print, so you’ll know exactly what is covered and what you can expect to pay. Choosing the right plan provides peace of mind. It’s also a proactive way to ensure you get the healthcare coverage you need and deserve.