Medicare in Louisiana
- Do you have Medicare coverage? Find out about Medicare in Louisiana, including who is automatically enrolled and who needs to apply.
What Louisiana Medicare Plans Are Available?
Medicare helps reduce the cost of health care for seniors and people with disabilities. Plans differ greatly in terms of costs and coverage, so it's important to consider which plan or combination of plans is most cost effective for your needs.
Louisiana residents can enroll in Original Medicare through the federal government or Medicare Advantage through private insurance companies. Both plans cover essential services when you're sick:
- Hospital insurance (Part A) helps pay for semiprivate rooms, meals and nursing care for inpatient hospital stays.
- Medical insurance (Part B) covers a wide range of doctor's services, tests and treatments. These include cardiac rehabilitation, chemotherapy, flu shots, transplants, emergency room visits and lab services.
Approximately 521,785 Louisiana residents are enrolled in Original Medicare. An additional 361,600 people receive benefits through a Medicare Advantage plan in the state.
Original Medicare only includes Part A and Part B services. It offers basic coverage through the federal government and doesn't offer other benefits such as dental cleanings, eyeglasses and hearing aids.
With this plan, you have the flexibility to use health care providers anywhere in the United States, as long as they accept Medicare. In most cases, you don't need to get the plan's prior approval for a service and may see a specialist without a referral.
Medicare Advantage includes Part A and Part B services and an array of extra benefits such as prescription drugs, vision, dental, hearing and gym memberships. These plans are offered in Louisiana through private insurers and are also known as Medicare Part C.
There are several types of Part C plans, each with different guidelines for the health care providers you can use:
- Health Maintenance Organizations typically only cover services provided through a local network of providers.
- Preferred Provider Organizations usually let you use any provider although some are designated as preferred and are less costly.
- Private Fee-for-Service Plans generally let you use any health care provider that accepts their payment schedule.
- Special Needs Plans are designed for beneficiaries with specific health conditions or needs and usually provide tailored care through specialists.
Medicare Advantage plans differ in terms of premiums, deductibles and copayments, so you may need to do some calculations to figure out which plan makes sense based on how much you use it.
Part D Prescription Drug Coverage
Prescription drug coverage, also known as Medicare Part D, is available in Louisiana no matter how you receive your Part A and Part B insurance.
- If you have Original Medicare, you can buy a separate Part D prescription drug plan from a private insurance company to help pay for your medications.
- If you have Medicare Advantage, you can choose a plan that includes drug benefits. Nine out of 10 Medicare Advantage plans help pay for prescription medicines. In most cases, you can't combine Part C and Part D plans, except with some Private Fee-for-Service plans that don't include a drug benefit.
While drug coverage is optional, you may want to join a plan even if you won't use the benefit right away. You can incur a permanent monthly penalty if you join a drug plan after you're first eligible.
Medicare Supplement Insurance
Medicare Supplement Insurance, or Medigap, is sold by private insurance companies to help pay for some Part A and Part B costs, such as deductibles, copayments and coinsurance. Medigap only works with Original Medicare, which doesn't cap out-of-pocket costs.
In Louisiana, there are 10 types of Medigap plans, each identified by a letter category (A-D, F, G, K-N). The Medicare website has a useful chart comparing the standard Medigap benefits included in each category.
Who Is Eligible for Louisiana Medicare?
Louisiana residents who are 65 or older or have disabilities generally qualify for Medicare insurance. Those who have been getting Social Security retirement benefits for a minimum of 4 months before their 65th birthday are enrolled in Original Medicare automatically by the government. You don't need to take further action unless you want to purchase private insurance.
- If you're not automatically enrolled by Social Security, you should sign up for Medicare during your 7-month initial enrollment period (IEP). Your personal IEP begins 3 months before the month you turn 65. If you join Medicare outside of this period, a late enrollment penalty is usually charged. During your IEP, you can also join a Part C or Part D plan.
- Your next chance to sign up is during Medicare's general enrollment period, held annually between January 1 and March 31. Your coverage is delayed and won't take effect until July 1.
- Medicare may give you a special enrollment period if there are circumstances that prevent you from enrolling in the above periods — for example, if you recently moved back to Louisiana from outside the United States or had other health coverage that ended.
- There is also an open enrollment period between October 15 and December 7 of each year. You can make changes to your Medicare coverage and join a Part C or D plan or return to Original Medicare.
How Do I Enroll in Medicare in Louisiana?
Louisiana residents who aren't automatically enrolled in Medicare may contact Social Security to sign up in one of three ways:
- Submit an online application through the Social Security website
- Call 1-800-772-1213
- Drop by your nearest Social Security office
Contact Information for Louisiana Medicare, Medicaid and Insurance Help
For more information about Medicare health insurance, consult the following resources:
- HelpAdvisor has useful information for Louisiana residents about Medicaid eligibility and enrollment for those meeting certain income thresholds.
- The Senior Health Insurance Information Program (SHIIP) provides Louisiana residents with free, confidential counseling to make decisions about Medicare coverage. You can contact SHIIP by calling the statewide, toll-free help line at 1-800-259-5300.
- The Louisiana Department of Insurance website has resources about assistance with Medicare costs, including the Medicare Savings Program and Extra Help for drug plans.
LouisianaSenioRX helps eligible low-income residents access prescription drugs at a discount through pharmaceutical assistance programs.