Louisiana Medicare Guide

Below you’ll find the basic information you need to know about Medicare in Louisiana, including the types of plans available to you and how to enroll.

If you’d prefer to speak with someone or have any questions about which type of plan is best for you, schedule a free consultation with one of our licensed Louisiana Medicare Advisors or call us now at: (888) 604-0055.

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A Snapshot of Medicare in Louisiana

There are 894,000 Medicare beneficiaries in Louisiana, making up 19% of Louisiana's total population. 27% of Louisiana Medicare beneficiaries also receive full or partial Medicaid benefits.

Enrollment in Medicare Advantage vs. Original Medicare in Louisiana

All Medicare beneficiaries can either stay on Original Medicare (Part A & Part B) or switch to a Medicare Advantage (Part C) plan. If you choose to stay on Original Medicare, you can also enroll in a Medicare Supplement plan to significantly reduce your out-of-pocket costs. Which option is best for you depends on your individual healthcare needs, so it’s best to speak with a Louisiana Medicare agent to understand the pros and cons of all of your options.

53% of Medicare beneficiaries in Louisiana are on Original Medicare (with or without additional coverage) and the other 47% are on a Medicare Advantage plan (source).

Louisiana Medicare Advantage Plans

Private insurance companies offer Medicare Advantage plans to give Medicare recipients an alternative to Original Medicare. Advantage plans are required to provide at least the same coverage as Original Medicare. They often provide additional benefits with low or $0 premiums, but you will still need to pay your Part B premium.

Medicare Advantage plans have out-of-pocket maximums to provide Medicare beneficiaries with financial protection for high-cost healthcare needs. Medicare Advantage plans also offer additional benefits, like:

Dental, vision, and hearing benefits
Over-the-counter cash cards
Fitness perks
Transportation services

When choosing the best Medicare Advantage plan for you, you want to be sure your healthcare needs are covered first! Make sure your prescriptions and preferred doctors are covered on the plan you choose. You should also know about the drawbacks that come with Medicare Advantage plans, including:

Limited provider networks
Preauthorization requirements
Higher out-of-pocket costs when compared to coverage from Original Medicare + Medigap

Louisiana has 67 Medicare Advantage plans available, but plan availability varies by zip code. For example, East Baton Rouge Parish has 38 Medicare Advantage plans available from nine insurance carriers and East Carroll Parish has ten plans available from five carriers (in 2023). To hear about and compare Medicare Advantage plans available in your parish, schedule a free consultation with one of our licensed Louisiana Medicare agents or call us today at (888) 604-0055.

Louisiana Medicare Supplement Plans

Original Medicare only covers about 80% of costs. Medicare Supplement (also known as Medigap) plans pair with Original Medicare to help cover the 20% of costs that Medicare doesn’t. They don’t provide coverage for additional healthcare services, but they do significantly reduce your out-of-pocket costs. Many Medicare beneficiaries choose to pair a Medicare Supplement plan with their Original Medicare coverage.

Medicare Supplement vs. Medicare Advantage:

You cannot have both a Medicare Advantage and a Medicare Supplement plan. Most people choose to stay on Original Medicare and get a Supplement plan OR to switch to a Medicare Advantage plan. When comparing Medigap and Medicare Advantage, Medicare Supplement has some key benefits that you will not get with a Medicare Advantage plan, including:

You can see any doctor who accepts Medicare (about 90% of doctors nationwide)
You don’t need to get prior authorization for covered services
Out-of-pocket costs are significantly reduced, and Medigap Plan G even covers your Part A deductible!

Plan G is often considered the best Medicare Supplement plan. Our lead advisor, Ari Parker often shares that his mother’s outpatient knee replacement would have cost her $8,000 if she didn’t have a Medigap plan. Instead, with her Plan G, she reached the 2022 $233 Part B annual deductible, and then owed nothing else.

The best time to enroll in a Medicare Supplement plan is when you first enroll in Medicare, during the Medigap Open Enrollment period. During this period, you cannot be denied coverage, regardless of your age or any pre-existing medical conditions. Outside of this time, and a handful of other guaranteed issue periods, insurance companies may ask about your health history and may deny you coverage.

The Louisiana Medigap Birthday Rule

Louisiana is one of a handful of states with a Medigap birthday rule. This rule allows Louisiana residents who are enrolled in Medigap plans to change plans once a year. Your birthday rule period starts on your birthday and lasts for 45 days. During this time, you can switch to a Medigap plan with equal or lesser coverage, and insurance companies cannot ask you medical underwriting questions.

Louisiana Part D (Prescription Drug) Plans

You can obtain Part D drug coverage either through a Medicare Advantage plan that includes it or through one of the 21 stand-alone drug plans available in Louisiana. The exact number of plans available to you will be based on the parish you live in. The average monthly premium for Medicare drug plans in Louisiana is $38.49.

When choosing your drug plans, be sure to check the list of covered drugs to be sure your prescriptions are covered. One of our Louisiana Medicare Advisors can help you compare the cost of drug plan premiums and the cost of your prescriptions to save you the most money. Even if you don’t currently use any prescriptions, it’s generally recommended that you enroll in a low-cost option to avoid the Part D late enrollment penalty later.

Get help with prescription drug costs with Medicare’s Extra Help Program

If you have limited income and resources, you may be eligible for Extra Help, which is sometimes called a low-income subsidy. If you meet any of the following conditions, you will qualify for the Extra Help program automatically:

You receive full Medicaid coverage from Louisiana
Louisiana helps pay your Part B premium
You receive Supplemental Security Income (SSI) benefits

If you don’t automatically qualify for Extra Help, you can learn more about eligibility here. If you need help, you can speak with one of our Medicare Advisors, who can help you with the application process.

Get help paying for Medicare in Louisiana

Extra Help provides financial assistance for costs associated with prescription coverage for Medicare beneficiaries. The following two government programs help pay for other Medicare costs.

Medicaid

Medicaid is a joint state and federal program that helps low-income individuals get access to healthcare. Medicaid programs are operated by each state, and Louisiana’s Medicaid program is run by the Louisiana Department of Health.

Medicare Savings Programs

Each state has Medicare Savings Programs (MSPs) specifically to help low-income Medicare beneficiaries pay for Medicare-related expenses. There are four programs with varying eligibility requirements and benefits.

Qualified Medicare Beneficiary (QMB) Program

Louisiana has two categories of QMB benefits:

QMB Only:

If you’re eligible for Louisiana’s QMB Only benefits, you’ll receive Medicaid payments for:

Medicare Part A and Part B premiums
Medicare deductibles
Medicare coinsurance

QMB Plus:
If you’re eligible for the QMB Plus benefits, you’ll receive all QMB Only benefits as well as the full range of Medicaid services.

Specified Low-Income Medicare Beneficiaries (SLMB) Program

Like the QMB Program, the SLMB Program has two categories.

SLMB Only

If you’re eligible for SLMB Only benefits, you’ll receive Medicaid payments for the Part B premium only.

SLMB Plus

If you’re eligible for SLMB Plus benefits, you’ll receive Medicaid payments for the Part B premium and will also receive the full range of Medicaid services.

Qualifying Individuals (QI) Program

If you’re eligible for the QI Medicare Savings Program, you’ll receive Medicaid payment for the Part B premium.

Qualified Disabled and Working Individual (QDWI) Program

If you’re eligible for the QDWI Program, you’ll receive payment for your Medicare Part A premium only.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

You are 65 and older, blind, or have a disability
You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

Louisiana Medicare Eligibility and Enrollment Steps

Regardless of where you live, if you’re a US citizen and you meet one of the following conditions, you are eligible to enroll in Medicare:

You’re 65 or older
You have certain disabilities, like End-Stage Renal Disease or ALS

Three key steps for Louisiana Medicare enrollment:

Enroll in Original Medicare during your Initial Enrollment Period
Choose your additional Medicare insurance coverage
Medicare Supplement (Medigap)
Medicare Advantage (Part C)
Part D (drug coverage)
Find doctors who are in-network, share your Medicare information with your pharmacy, and set up any additional benefits (if you have Medicare Advantage).

Medicare doesn’t have to feel overwhelming. We help older Americans understand their options, get through enrollment, and receive the best value from Medicare year after year. If you have questions or need help, schedule a free consultation here, or simply call us at: (888) 604-0055. We’re happy to help, and our advice is always free!

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