Any Louisiana resident who is at least 65 years of age has the option to enroll in Medicare. When you enroll, you automatically start receiving benefits from Parts A and B (see the table below for specific descriptions on what each part provides). These first two parts, often labeled as “Traditional” or “Original” Medicare, are designed to cover the majority of your health care needs during your retirement years.
Coverage and Benefits
Original Medicare starts out as a fairly affordable policy. Part B requires a monthly premium and an annual deductible, and you can find out what those costs are by visiting this page. Part A might be free for anyone with a lengthy work history. You’ll need at least 10 years (or 40 quarters) of experience, otherwise you might have to pay a fee for Part A benefits.
Some seniors may not know that Medicare Parts A & B aren’t necessarily a package deal. When you first qualify for Medicare, you may choose whether or not you would like to accept (and purchase) Medicare Part B benefits. This is assuming you don’t choose a Medicare Part C plan, that is. Also, if you choose not to purchase Part C coverage, you will have to at least accept and pay premiums for Medicare Part A benefits in order to get any benefits at all.
The reason Medicare Part C changes things so drastically is because it is a private health insurance plan which replaces Original Medicare. With such an insurance policy, you must accept and pay for the equivalent of Medicare Parts A & B. Part B also becomes mandatory if you accept Original Medicare but you also want to purchase Part D prescription-drug coverage. You cannot get prescription drug benefits if all you’re paying for is Medicare Part A.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
The Variety of Medicare Insurance Programs in Louisiana
If you are a retirement-aged individual living in Louisiana right now, then odds are you are one of the 718,037 people currently receiving Medicare benefits. Of those, 28% (201,050 people) are getting their Medicare benefits from a Medicare Part C, or Medicare Advantage policy. And additional 16% (115,640 individuals) are supplementing their Medicare with a Medigap supplement insurance policy. Finally, 56% of Louisiana Medicare recipients are either supplementing their health care needs with some sort of employer benefit, or have no protection from the disastrous gaps in Medicare coverage at all.
Are you new to the federal Medicare program? For more information on Medicare enrollment and benefits, click the provided link.
If I Live in Louisiana, Will I Need Medicare Supplement Insurance?
No matter where you live, purchasing supplement coverage for your Medicare benefits is a good idea. For the record, though, it is not a requirement, legally or otherwise. The decision is yours to make. If you are relatively young and still fairly healthy, you might not think you need the extra expense per month. But if you don’t have it, and you are relying on Original Medicare alone, any sudden catastrophic change in your health could leave you vulnerable to the following expenses:
|Medicare Part A Costs||Medicare Part B Costs|
Supplemental policies protect you and your finances from the expensive gaps in Original Medicare. Without coverage, the dollar amounts quoted above are just the tip of the iceberg. There’s no telling how many thousands of dollars you may be required to pay if you suffer an unforeseen medical emergency.
Louisiana’s a wonderful state; unfortunately, the rising costs of healthcare for seniors is not. Retirees have the added challenge of living off their life savings because they are no longer working and therefore do not have a steady income. Hopefully, you’ve had plenty of opportunity in your lifetime to save up a comfortable amount of money to live off of for the rest of your life. But there are plenty of Health crises which can take a serious toll on your retirement funds.
Medicare is designed to help protect seniors and their savings from The Staggering costs of healthcare which are common during their golden years. Unfortunately, Medicare will not protect you from everything. Hospice Care, extended hospital stays, and coinsurance payments out of control are not covered by Medicare and will have to be covered by you. That is, unless you purchase a Medicare supplement insurance plan.
There’s a wide variety of supplements you can purchase depending on your needs. Pretty much all of them are offered by private companies; but they differ in how much they cover, and how closely they work with the government to make sure your healthcare costs are taken care of. Unfortunately, there’s no one-size-fits-all type of Medicare supplement insurance that will benefit all seniors. The supplemental plan you decide to purchase will depend entirely upon your specific needs.
In order to protect yourself from Medicare gaps, you should look into either a Medicare Advantage policy or a Medigap Insurance supplement. Both have the potential to give you the coverage you need at an affordable price. But this potential may be different based on your own personal needs.
Coverage Option #1: Medicare Supplement Plans in Louisiana
Medigap – which is a clever amalgamation of the words “Medicare” and “gap” – is a type of supplemental policy designed to protect you from the coverage gaps associated with Original Medicare. It is separate from your Medicare benefits, and is underwritten by a private insurance company. The federal government has worked closely with health insurance providers to design ten plans which will give you the best protection at the most affordable cost: Plans A-D, F, G, and K-N. Each plan is identical, regardless of your location. But the overall expense and the company offering your policy will vary by location.
For a comprehensive description of what each plan offers, take a look at the table below:
Top Medicare Supplement Plans in the Area
|Type||Starting From||Part A Deductible||Part B Deductible||Excess||Nursing||Travel|
|F||$94||$0||$0||100% Covered||100% Covered||100% Covered||Request Info|
|C||$93||$0||$0||Not Covered||100% Covered||100% Covered||Request Info|
|G||$85||$0||$147||100% Covered||100% Covered||100% Covered||Request Info|
|B||$96||$0||$147||Not Covered||Not Covered||Not Covered||Request Info|
|N||$74||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|D||$91||$0||$147||Not Covered||100% Covered||100% Covered||Request Info|
|A||$79||$1||$147||Not Covered||Not Covered||Not Covered||Request Info|
|L||$73||$304||$147||Not Covered||75% Covered||Not Covered||Request Info|
|K||$48||$608||$147||Not Covered||50% Covered||Not Covered||Request Info|
|M||$98||$608||$147||Not Covered||100% Covered||100% Covered||Request Info|
Coverage Option #2: Medicare Advantage Plans in Louisiana
Medicare Part C, sometimes also referred to as Medicare Advantage, is a private alternative to your government-sponsored Medicare Parts A & B. When you purchase a Medicare Advantage policy, you begin receiving your benefits from a private health insurance company and the government is no longer responsible for your care. The good news, however, is that your benefits will be protected by law. It is illegal for anyone offering a Medicare Advantage policy to give you fewer benefits or inferior coverage compared to Traditional Medicare.
Some of the pros associated with Medicare Advantage are its simplicity and possible additional benefits (although many of those benefits come at an additional cost). Only dealing with one company is a relief for some. And the added benefits, such as prescription drug coverage or dental which are not offered by Original Medicare, are a nice touch – even if you do have to pay a little extra for them. However, if you are particularly attached to your current doctor, then do a little digging into your Medicare Advantage plan’s network before you buy a policy. Some of their PPO and HMO networks are notoriously limited, and you may have to switch physicians.
Are you familiar with Health Maintenance and Preferred Provider (HMO and PPO) Organizations?
Comparing Louisiana Medigap vs. Medicare Advantage
The simplest and easiest to understand of these policies is Medigap. Medigap is designed specifically with Medicare coverage gaps in mind. While it may not offer the fancy extras that a Medicare Advantage policy might, it can be a much more affordable option for a good number of seniors. It can cover the costs of certain blood transfusions, lengthier hospital stays, and even help pay for your Original Medicare premiums if you purchase the right policy.
Compared to a Medigap supplement, a Medicare Advantage plan is a much bigger and bulkier Beast. Medicare Part C is actually a private health insurance plan as opposed to being offered directly from the government. It works exactly as your pre-retirement health insurance would. But there are two differences: the government will pay a portion of your monthly premium, and you must accept the same type of healthcare benefits that you would get if you were paying for Medicare Parts A & B. You will also have the flexibility to add extra coverages as needed for eye care, dental care, or prescription drugs.
Unfortunately, there are certain inherent risks with Medicare Advantage that most seniors aren’t aware of. The medical networks tend to be more restrictive, meaning that you may have to switch doctors or get care from a subpar facility. you’ll also have to be very specific about purchasing coverage to protect yourself from Medicare gaps – these policies don’t automatically come with those benefits the way a Medigap policy does. There’s also a pre-approval process and fewer guarantees that your coverage will not be discontinued in the future.
For some people, there are more advantages with Medicare Part C; but for many seniors, Medigap policies are the more affordable option with just the coverage they need and nothing they don’t. If you still haven’t made up your mind, let us help! Just reach out to one of our helpful customer service representatives and they can make a sound recommendation based on your personal health care needs. They may even be able to find you an affordable insurance quote today.
In the table below, we’ve highlighted some important differences between these two popular forms of supplemental insurance. Plan cancellations, monthly premiums, and budgeting ability are all very important, yet very different aspects of each plan:
|Questions||Medicare Advantage||Medicare Supplement|
|How are expenses covered under each plan?||It starts with the government paying for most – if not all – of your monthly premium. Your insurance provider calculates these costs, and sent you a bill for what Uncle Sam doesn’t pay||The most comprehensive plans only charge you one low monthly premium. Less comprehensive plans may leave your pain medicare premiums, coinsurance, or co-pays|
|Will I still have to pay for Part B?||Yes||Yes|
|What will it cost me?||This will largely depend on how much government assistance do you get for your monthly premium as well as the frequency with which you receive Medical Care||Beyond your monthly premium for a comprehensive plan like Plan F, you will have very few other medical expenses|
|What will the plan cover?||Medicare Advantage starts by offering the exact same benefits as Medicare Parts A & B. Additional coverages and benefits will be up to you||All of the gaps in Medicare coverage – including hospital stays, blood transfusions, healthcare while abroad, and more – are covered. Extra coverages like dental, vision, or prescriptions are not available|
|Is it easy to budget my health care expenses?||Frequent hospital visits and trips to the doctor, along with outpatient treatments and hospice care, will be more expensive and more difficult to budget for with Medicare Advantage||The more comprehensive your Medigap plan, the fewer extra expenses you will have; some seniors only needs a budget for their monthly premium with Comprehensive plans like Plan F|
|Is my plan guaranteed? Or can it be cancelled?||Like most other health insurance policies offered by private companies, your insurance provider may decide to cancel your coverage if they have a legal reason to do so||Your coverage cannot be as long as the company remains financially stable and you pay your premiums on time every month|
|Do I have to clear a pre-approval or pre-certification process?||Almost all private health insurance companies require a pre-approval process; Medicare Advantage providers are no exception. If you cannot pass, you may be denied coverage||As long as you are already qualified to receive medicare benefits, you are guaranteed coverage if you purchase a Medigap policy|
|Am I limited to specific doctors or hospitals?||Medicare Advantage plans do you have fairly restrictive Networks; but in high population areas, this keeps costs down while still providing you with a decent amount of choice||As long as the doctor, hospital, or facility where you want care accepts Medicare, they will accept your Medigap insurance, too|
|What type of plan is best for me?||Younger seniors who are in the best health and live in a big city could potentially find savings with Medicare Advantage. It also gives them more options with regard to dental, vision, and prescription drug coverage||If you are older, if your health isn’t perfect, if you live in a fairly rural area, and if you are primarily focused on Medicare coverage gaps, then it would behoove you to look into a Medigap insurance policy|
Additional Medicare Resources in Louisiana
If you have any further questions, please take a minute to look at the directory below. In it you will find a plethora of resources and contact information for experts in the Medicare field. They will be more than happy to answer any questions or concerns you may have regarding your health care benefits.
Choose at least one topic area you are interested in: Select All
Help with my Medicare options & issues
Other insurance programs
Complaints about my care or services
General health & health conditions
Claims & billing
Health care facilities & services in your area
Important Medicare Terms
- HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
- PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
- Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
- Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
- Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.