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Medicare in Louisiana

See what’s cooking with Medicare in Louisiana, from costs to coverage

Reviewed by: Ed McClane, Licensed Insurance Agent. Written by: Aaron Garcia.

Key Takeaways

  • Medicare in Louisiana a health insurance program by the federal government and is available to all legal U.S. residents aged 65 and older. Legal residents who have lived in the U.S. for five or more years may also be eligible.

  • Original Medicare (Parts A and B)Original Medicare (Parts A and B) is fee-for-service health insurance available to all Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). helps cover hospital and medical costs. Medicare Advantage (Part C)Medicare Advantage is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). is an alternative that replaces Original Medicare’s Parts A and B that often provides dental, vision, and prescription drug coverage.

  • The price of Medicare in Louisiana starts with several standardized costs, but what you end up paying will depend on your needs and plans.

 

If you are 65 or older and have questions about health insurance, you should get up to speed with Medicare in Louisiana. But, unfortunately, no one’s ever referred to Medicare as The Big Easy.

But that doesn’t mean finding information on Medicare plans in Louisiana needs to be complicated. Instead, GoHealth can help you answer some critical questions. How much is Medicare? What is Medicare Advantage in Louisiana, and what are all of your options? How do you sign up?

If you’re looking for answers to questions like these, check out GoHealth’s guide to Medicare in Louisiana.

Or should we say, GeauxHealth?

Who Qualifies for Medicare in Louisiana?

To qualify for Medicare in Louisiana, you need to be 65 or older and either a legal U.S. citizen or a legal resident of at least five years. Some situations may qualify you for Medicare before 65, including:

How do I apply for Medicare in Louisiana?

Are you approaching your Initial Enrollment Period (IEP) and need to sign up for Medicare in Louisiana? There are several ways for Louisianians to enroll, whether with impartial help from a licensed insurance agent at GoHealth or through the Social Security Administration (SSA). To apply for Medicare:

  • Contact GoHealth. One of our licensed insurance agents will help you enroll while answering your questions.
  • Apply online at the SSA website. [1]
  • Call the SSA at 1-800-325-0778.
  • Visit your local SSA office. [2]
  • If you worked for the railroad, you might need to apply through the Railroad Retirement Board (RRB). For more information, call the RRB at 1-877-772-5772.

What is the Best Medicare Advantage Plan in Louisiana?

If you’re looking for the best Medicare Advantage in Louisiana, it depends on your specific needs and other details, like where you live. Also, availability varies by location, and what works for someone in New Orleans may not fit a person in Homa. To figure out which Medicare Advantage plans may work for your needs, here is a breakdown of the main types of policies and how they work:

  • Health Maintenance Organization (HMO): HMOs use primary care physicians to manage care. With HMOs, you can mainly see doctors within your provider network.
  • Preferred Partner Organization (PPO): With a PPO, you have greater freedom to visit out-of-network doctors and providers.
  • Private Fee-For-Service (PFFS): PFFS policies provide separate payments to your providers for each service you receive.
  • Special Needs Plan (SNP): SNPs are designed for patients living with certain diseases or health conditions. [3] D-SNP plans assist dual-eligible individuals; C-SNP plans are for patients with chronic diseases.

How Much Do I Pay for Medicare in 2021?

Are you or a loved one shopping for Medicare and need to put together a budget? The cost of Medicare plans in Louisiana starts with a handful of standard costs. However, you’ll pay for Medicare depending on your needs and the specific plan you choose. To give you an idea of your expenses, here are Original Medicare’s standard prices for 2021:

Medicare in LA: Part A

Premium:

  • $0 if you or your spouse worked 10 or more years
  • $259 a month if you worked between 7.5 and 10 years
  • $471 a month if you worked fewer than 7.5 years

Deductible:

  • $1,484 each plan period

Copayments & Coinsurance:

  • Hospital stays: $0 copay for Days 1-60 following deductible payment; daily charges for Days 61 and after
  • Skilled Nursing Facility: $0 for Days 1-20 (each plan period); daily charges for Days 21 and after

Medicare in LA: Part B

Premium:

  • $148.50 monthly and up (income-based)

Deductible:

  • $203 for each plan period

Copayments & Coinsurance:

  • Most preventative services: $0
  • Medicare-approved services: 20% coinsurance

Medicare in LA: Part D

Premium:

  • Income-based; varies by plan

Deductible:

  • No more than $445 in 2021

Copayments & Coinsurance:

  • Plan- and drug-specific

What Medicare Plans are Required at 65?

You are not required to have Medicare in Louisiana. However, not enrolling when you’re first eligible can leave you with heavy enrollment penalties when you do sign up.

These fees are avoidable, however, by enrolling when you’re first eligible for Medicare in Louisiana. Here are the three parts of Medicare that will charge enrollment penalties if you don’t:

You may be able to delay your enrollment if you (or your spouse) are working and you receive coverage through that employer’s plan when you turn 65. If so, a Special Enrollment Period will open once that coverage ends. This is an eight-month window during which you can enroll in Parts A and B after 65 without penalty.

What Are the Different Medicare Plans Available?

There are two main ways to receive medicare in Louisiana: Original Medicare (Parts A and B) and Medicare Advantage. Each has its own pros and cons. Depending on which of these you choose, you may also be able to supplement your coverage with other Medicare parts to round out your health care.

Here is more information on the different Medicare plans in Louisiana:

 

MEDICARE IN LA: PART A

The hospital portion of Original Medicare (Parts A & B). This helps cover:

  • Inpatient care.
  • Some home health care.
  • Skilled nursing home care.
  • Hospice care.

 

MEDICARE IN LA: PART B

The medical portion of Original Medicare (Parts A & B). This helps cover:

  • Medical treatment from doctors and other providers
  • Some home health care
  • Outpatient treatments
  • Some durable medical equipment, including wheelchairs

 

MEDICARE IN LA: MEDICARE ADVANTAGE (PART C)

Medicare Advantage in Louisiana is an alternative to Original Medicare.

  • The Parts A and B you receive from Medicare Advantage replace Original Medicare Part A and Part B.
  • These plans often include other coverages, including dental, hearing, vision, and prescription drugs.
  • Medicare Advantage plans in Louisiana must provide at least the same level of care as Original Medicare.

 

MEDICARE IN LA: MEDICARE PRESCRIPTION DRUGS (PART D)

Prescription drug coverage provided in part by private insurers.

  • Generic, name-brand, and specialty drug tiers.
  • Commercially available vaccines not covered by Medicare Part B.

Original Medicare enrollees often have trouble with the out-of-pocket costs that can come with Part A and B benefits. To help with this, you can purchase Medicare Supplement Insurance (Medigap). Here’s an overview:

 

MEDICARE IN LA: MEDICARE SUPPLEMENT INSURANCE (MEDIGAP)

A collection of private plans that help cover copayments, coinsurance and deductibles, and other services.

  • In Louisiana, these 10 plan options are labeled by letters from A to N.
  • Paid separately from your Original Medicare.
  • Cannot be used with Medicare Advantage.

Are Medicare Advantage Plans a Ripoff?

Whether enrolling in Original Medicare or Medicare Advantage in Louisiana, figuring out which plan gets you the most health value comes down to several factors. Where you live, how long you worked and how much you made — all of these will impact your plan and how you feel about it. Medicare Advantage isn’t the best fit for every Louisianian. But for some, the value they get from Part C’s extra coverages are enough to switch from Original Medicare.

The point? Decide for yourself what you think about Medicare Advantage in Louisiana. Here are some steps you can take to weigh your choices:

  • Learn the different Pros and Cons of Original Medicare and Medicare Advantage in Louisiana.
  • Review your needs with our Enrollment Checklist.
  • Learn how to read the Medicare Star Ratings and see how plans stack up.
  • Get our Pro Tips for making Medicare easier.
  • Receive impartial guidance and needed answers from a licensed insurance agent at GoHealth. One quick call will help you figure out which plans fit your needs — even if that means Medicare Advantage. Give us a call at 1-855-792-0088.

Medicare in Louisiana by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 814,708 people are enrolled in Medicare in Louisiana. The total number of beneficiaries enrolled in Medicare Advantage in Louisiana is 321,893. The previous year, 295,384 enrolled in Medicare Advantage. Medicare Advantage participation in Louisiana went from 37.06% to 39.51% year over year. If you’d like to dive deeper into how Medicare in Louisiana breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Louisiana
814,708
Beneficiaries with Part A & Part B
321,893
Medicare Advantage Beneficiaries
39.51%
Medicare Advantage Participation Rate
54.58%
% Female
45.42%
% Male
1.07
Average HCC Score
$11,348.81
Actual Per Capita Costs
28.81%
% Eligible for Medicaid
35.24%
% of Beneficiaries with an Emergency Department Visit
18.65%
Hospital Readmission Rate
70.29%
% Non-Hispanic White
25.20%
% African American
1.97%
% Hispanic
2.55%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Louisiana Medicare Resources & Contacts

Beneficiaries spend an average of $11,348.81 each year on Medicare in Louisiana. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Louisiana-based resources, like these, may be able to help:

Louisiana Department of Insurance

1-800-259-5300

https://www.ldi.la.gov/home

What should I know about the Louisiana Department of Insurance?

Visit LDI to access financial assistance through the state’s Medicare Savings Program and SeniorRx.

Louisiana Medicaid

1-888-342-6207

https://ldh.la.gov/index.cfm/subhome/1

What should I know about Louisiana Medicaid?

Louisiana’s health insurance for low-income adults, families and children.

Louisiana Department of Health

1-225-342-9500

https://ldh.la.gov/

What Should I know about the Louisiana Department of Health?

File complaints, report abuse and fraud; info on home, community-based and long-term care.

Governor’s Office of Elderly Affairs

1-225-342-7100

http://goea.louisiana.gov/

What Should I know about the Governor’s Office of Elderly Affairs?

Oversees the state’s Area Agencies on Aging and provides community-based and long-term resources.

Nationwide Resources

Speak with an insurance agent that is licensed in Louisiana about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in LA, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

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