The original Medicare or the traditional Medicare program consists of Part A and Part B. This free-for-service health insurance plan covers basic medical expenses:
Part A provides coverage for hospital services like inpatient treatments, lab tests, hospice care, specialized nursing facilities, etc.
Part B pays for outpatient care, doctor appointments, mental health, in-home care, partial hospitalization, and certain medical equipment.
The Original Medicare plan Part A and Part B cover 80% of the total medical expenses. While for the leftover 20% coinsurance, beneficiaries have to purchase a secondary healthcare policy like Medigap, which is funded by private insurers. With the original Medicare Part B, you will also be charged a monthly premium unless your financial situation does not allow it.
Supplemental Health Insurance – Medigap Options in Louisiana
Where the original Medicare Part A pays 80% of the total inpatient care and skilled nursing facilities and Part B covers outpatient care and other necessary medical supplies, many enrollees search for options that pay the rest of the 20% of their hospital expenses.
This is why many people of Louisiana sign up for a supplemental healthcare policy called Medigap.
Medigap, also known as Medicare Supplement, is a comprehensive private health insurance policy that Medicare beneficiaries purchase to get coverage for what isn’t covered in the original Medicare. This set of secondary coverage policies is labeled from A through N.
Private insurers that provide Medigap plans must adhere to federal regulations. Medigap plans are governed by every state’s insurance commissioners and laws.
It’s necessary to be enrolled in original Medicare Part A and Part B to be able to apply for Medigap. You can sign up for the Medigap healthcare plan the first month after you apply for Medicare Part B.
You must be 65 years old or older to become eligible for Medigap. People who have been diagnosed with amyotrophic lateral sclerosis or end-stage renal disease also qualify.
Medigap insurers in Louisiana set their premiums in three ways:
This premium is calculated depending on the enrollee’s age. Enrollment premiums cost much less for people who are under 65 than for people over 80. The overall rates may rise due to inflation and other reasons, but not in response to the enrollee’s age.
Most insurance companies prefer to use the attained-age rating method. The person’s premiums go higher as they become older. This way, this premium is less expensive for younger buyers.
This premium is not affected by the age of the enrollee. Insurers are likely to avoid this premium unless it is mandated.
Insurance companies in Louisiana usually prefer to use the issue-age rating while others use the attained-age rating.