Medicare Agent

Louisiana

Medicare Options in Louisiana

People work hard their entire lives to make a living and save a little bit on the side for a comfortable retirement just to finally have the chance to kick back, relax, and enjoy their time. But a single unforeseen excessive medical expense can become an inevitable setback and quickly lead to financial trouble.

According to many reports, numerous people in the US aged 65 and above face medical debt and bankruptcy right after going through a health issue situation in their household. On the other hand, people with disabilities are more likely to be in debt because of outstanding medical bills since they require extra services and equipment that they cannot pay for themselves.

This is why the Medicare health insurance program was initiated to provide ample healthcare coverage for people who are facing exorbitant medical expenses and on the brink of bankruptcy. You become automatically enrolled in Medicare coverage once you reach the age of 65. Younger people who have received 24 disability benefits payments or have had a renal failure or ALS are also eligible for this government-backed healthcare program. With proper health insurance coverage, you will never have to worry about breaking the bank at the time of a health emergency.

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Since there are numerous healthcare programs to choose from, it’s essential to opt for a coverage plan that is best suited to your needs and financial situation. This is where our Medicare insurance agents come in.

At Integrity Now Insurance Brokers, our highly-qualified team of insurance agents is annually accredited by America’s Health Insurance Plan (AHIP). With our in-depth knowledge of the workings and the complexities of the industry, we will make sure you have a robust healthcare plan that will help you stay debt-free and stress-free. Our insurance agents will work with you to streamline the best healthcare plan and ensure you’re getting health coverage that covers all the bases.

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Original Medicare

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.

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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:

Issue-age Rating

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.

Attained-age Rating

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.

Community Rating

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.

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Although there are ten basic Medigap plans to choose from, the people of Louisiana prefer Plan F, N, and G the most.

Medigap Plan F

The Medigap Plan F is one of the most popular coverage plans that cover most of the coverage gaps in the traditional Medicare Part A and B.

Medigap Plan F covers the Medicare Part B annual deductible (which is $233 in 2022), the Medicare Part A coinsurance, and hospital expenses for up to a year after using Medicare benefits. This healthcare plan eliminates the financial burden of international trips, specialized nursing care, and hospice as well.

Medigap Plan N

A reliable alternative to Plan F, Medigap Plan N is less costly and includes all of Plan G’s coverage.

If you’re enrolled in the Plan N, you will be expected to pay for copayments for doctor appointments and hospital stays. The Part B annual premium is not covered in this plan, and you will be responsible for up to $20 for in-office visits and $50 for emergency room visits.

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Medigap Plan G

The Medigap Plan G offers the same benefits as Plan F, along with the coverage for the Part B deductible. With Plan G, you don’t have to pay for Part A premiums, hospital costs, coinsurance, hospice copay, and specialized nursing facilities either. This plan also has an added bonus of 80% coverage for foreign travel emergencies.

First-time Medicare enrollees can find the process of enrolment intimidating and are usually on the lookout for an expert’s assistance to help them find the right healthcare plan. At Medicare Hope, we are committed to making things as simple as possible. Our Medicare insurance agents walk you through your healthcare coverage policy line-by-line and find a plan that is best suited to your specific needs and budget.

To learn more about the different Medicare options, make sure to go through our blog and gain more insight about applying to Medicare.

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Medicare Advantage in Louisiana (Part C)

Even though the supplementary Medigap plans provide ample coverage, there is also an option to opt for Medicare Advantage Plans in Louisiana. This insurance plan is provided by private insurers who work under contract on the terms and conditions of Medicare, offering an all-in-one solution of healthcare benefits.

The Medicare Advantage plan is a conglomeration of Part A, Part B, and Part D (prescription drug coverage) coverage plans combined into one.

Some additional benefits offered by Medicare Advantage include dental, vision, hearing, transportation to doctor appointments, over-the-counter drugs, gym membership, and other health and wellness support programs.

There are four types of Medicare Advantage plans in Louisiana:

Health Maintenance Organization (HMO)

Most HMOs mandate their user to only opt for in-network providers for healthcare services.

This collective of medical insurance providers pays for medical treatments by doctors and hospitals that are under contract with them. People who have a PCP (primary care provider), a specialty referral, and approval for certain treatments and drugs qualify for the HMO.

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Preferred Provider Organization (PPO)

Medicare PPO plans have a recommended network of providers, but you also have the option to choose an out-of-network healthcare provider for a higher price.

This plan has no PCP or specialty referral requirement
It covers prescription drugs
You cannot purchase drug coverage separately
Includes higher out-of-network charges and premium

Private Fee-For-Service (PFFS)

Offered by State-licensed organizations that agree to the terms and conditions of the Center for Medicare & Medicaid Services, the PFFS plan does not require specialty referrals and PCPs.

You can consult Medicare-approved healthcare providers at any time
Drug coverage can be included or purchased separately
You will have to pay more to consult an out-of-network provider

Special Needs Plan (SNP)

This plan is only available for people who have certain medical conditions. That’s because this healthcare plan features care and benefits that are specially designed to meet their specific needs.

PCP and specialist referrals are required
Drug coverage included
You can join this plan anytime if you meet the eligibility criteria

Louisiana Medicare Part D

Since Medicare Part A and Part B do not cover outpatient prescription medications, Part D is a separate coverage plan that provides comprehensive coverage for prescription medicine.

This creditable optional Medicare coverage policy is the perfect solution to prevent any out-of-pocket expenses that could be spent on drugs. This plan includes chemotherapy drugs, intravenous medications, and other over-the-counter drugs as well.

In 2022, 55% of the people in Louisiana have stand-alone Medicare Part D plans, and the number is continuously on the rise due to the increasing drug rates nationwide.

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Comparing Medicare Advantage Plans in Louisiana

About 42% of the residents of Louisiana are enrolled in Medicare Advantage. With so many options available, finding a plan that covers all the bases and meets your budget is not easy. Make sure to consult with a Medicare insurance agent before you make a final decision.

Here are some factors to consider when selecting a Medicare healthcare plan.

Provider Network

Many Medicare plans require the beneficiaries to consult with healthcare providers that are under a contract with them. For an out-of-network provider, you will have to pay a higher cost. Make sure you do your research and find the physicians and hospitals that are a part of the network so you can save money on medical bills.

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Amount of Coverage Required

Take your primary needs and requirements into consideration before opting for a plan. Medicare Advantage and Medigap plan usually cover additional dental, vision, hearing, and other wellness benefits which aren’t included in Part A and Part B. Make a list of your specific requirements and choose a plan that fulfills them all.

Check Plan Ratings

The Center for Medicare & Medicaid Services (CMS) releases Part C and Part D performance data annually, which you can go through to compare ratings before the enrollment period begins.

Out-of-Pocket Expenses

These include deductibles, copayments, and coinsurance which you will be expected to pay yourself. To compare the pricing on different plans in Louisiana, you can use our plan finder tool by clicking here.

Monthly Premium

Medicare Advantage and Supplement plans add a premium to your monthly budget, and you will have to pay for the Part B deductible whether you use you are using your benefits or not.

Drug Coverage

Since prescription drugs are expensive, ensure that your plan had adequate coverage for them. You can consult with the policy’s formulary to find out how much your drugs will cost. Get in touch with your physician to find out any alternative or generic drug options for any medication that isn’t listed in the formulary.

Deductibles, Coinsurance & Copays

Before signing up for a plan, find out all the specifics of the hospital and medical coverage. You will be responsible for any deductibles, coinsurance, and copays so make sure to do your research beforehand.

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Medicare Enrollment in Louisiana

Initial Enrollment

The initial time frame for registration begins three months before and ends three months after your 65^th birthday. You can enroll yourself for Medicare in this time frame, but if you qualified for Medicare before you turned 65, you could use this time to switch or update your plan.

General Enrollment

If you miss out on the initial enrollment period, you can sign up for Medicare during the general enrollment period, which starts January 1^st and ends March 31^st. You can use this time to enroll in Original Medicare (Part A and Part B), Medicare Advantage, Medigap, and Part D.

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Open Enrollment

This three-month window starting from October 15th to December 7th, happens every year when you can make changes to your Part C plan.

Special Enrollment

If, for any reason, you lose your insurance coverage or your eligibility changes due to unforeseen circumstances, you can use the special enrollment period to sign up again.

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Why Trust Medicare Insurance Agents at Integrity Now Insurance Brokers?

Our team of Medicare insurance brokers is highly qualified and well-versed with the dynamics and the jargon of the industry. We can help you streamline the best health insurance plans in Louisiana with our extensive experience and network of A-rated Medicare Insurance Providers.

Our insurance agents are committed to going above and beyond for our clients and helping senior citizens, youths with disabilities, and other individuals who require instant healthcare solutions. We have helped countless people nationwide to land comprehensive health coverage plans at minimum rates, and we assure you that your health is our priority.

Reach out to our AHIP-certified team of Medicare insurance agents today, who will help you compare quotes and fill you in with all the details that you require. Call us now for a free consultation.

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