Louisiana Medicare Supplement Plans (Medigap)
Louisiana Medicare Supplement Plans, commonly known as Medigap, were created to work with Traditional Medicare. They provide coverage of out-of-pocket expenses that are not covered by Traditional Medicare.
Medicare is a federal health insurance program that is run by the Centers for Medicare and Medicaid Services, an agency of the U.S. Health and Human Services. But, it was not designed to cover 100% of medical costs.
Medigap coverage plans are sold by private insurance companies and are specially designed to supplement Medicare benefits. Like traditional healthcare insurance, the cost and coverage of these plans will vary from company-to-company.
Louisiana Medicare Benefits Explained
Medicare is broken down into four parts; Parts A, B, C, and D. Additionally, there are Medigap plans that may be added to cover any “gaps” in health coverage of Original Medicare.
- Part A- In Hospital Coverage & Part B– Medical Coverage. Together, Part A and Part B are known as Original Medicare and are available to anyone who is eligible for Medicare in any state.
- Part C- Medicare Advantage – Part C is a single plan that combines the coverage of Part A and Part B plans.
- Part D- Prescription Drug Coverage – Medicare Part D in Louisiana offers prescription drug benefits to Medicare beneficiaries through Medicare-approved insurance companies. Plan details and costs can vary by location.
- Louisiana Medicare Supplement Plans – They provide additional coverage for those enrolled in Original Medicare. Medigap plans help pay for additional medical costs that would otherwise be an out-of-pocket expense, such as deductibles, copays, and coinsurance.
Unlike Part A and Part B plans, Louisiana Medicare Supplement Plans costs can vary by location. For example, beneficiaries in New Orleans may not receive the same plan costs as those in Lafayette, simply due to location.
Health Benefits Covered by Medicare in Louisiana
In Louisiana, Medicare provides coverage for medical services that are deemed necessary by a physician. However, the Medicare beneficiary is liable for coinsurance at 20% of the cost.
This is where a Medigap plan would help alleviate out-of-pocket expenses. It would cover some, if not all, of the 20% coinsurance as well as other out-of-pocket expenses that may be incurred and that would otherwise be your sole responsibility to pay.
Eligibility for Medigap in Louisiana
In order to be eligible for a Medigap plan in Louisiana, you must be 65 years or older and be enrolled in Medicare Part A and B (Original Medicare). You may also be enrolled in a Medicare Part D plan in conjunction with Part A and B.
It is important to note that there is a financial penalty that will be added to your monthly premium if you sign-up late for Medicare. The Initial Enrollment Period (IEP) to sign-up for Medicare is a 7-month window around you 65th birthday, being 3-months prior to, the month of, and 3-months following.
Louisiana Medicare Open Enrollment Period
If you do not enroll in Medicare within this time frame, you may enroll during the Open Enrollment Period (OEP) which runs from October 5th through December 7th. However, if you do not enroll during your IEP and choose to then enroll during and OEP, you will incur the financial penalty.
If you are 65 or older and are still covered by employer or union-sponsored health insurance, you will not incur the financial penalty for enrolling in Medicare past your 65th birthday. That is as long as you enroll as soon as your employee or union coverage ends.
Some individuals will automatically be enrolled in Medicare and will not need to worry about the IEP and penalties. Individuals who will be automatically enrolled are those who receive retirement benefits through the Social Security Administration (SSA) or the Railroad Retirement Board (RRB).
Louisiana Medicare Benefits for the Disabled Under 65
Some people under the age of 65 qualify for Medicare benefits Part A and B. These individuals are disabled and meet certain requirement to qualify.
If you have received disability benefits from Social Security or certain disability benefits from RRB for more than 24 consecutive months, have Amyotrophic Lateral Sclerosis (ALS), or End-Stage Renal Disease (ESRD) you qualify for Medicare Part A and B as disabled.
Medigap Premiums in Louisiana
Medigap coverage plans are sold by private insurance companies. Each of these companies set their own monthly premiums. Several factors may come into play when these companies set their premiums, such as age, sex, and location.
Once enrolled in a Medigap plan, the Medicare Supplement rate guarantee, also known as Medigap protection, guarantees, by law, that the plan is renewable.
The Top Louisiana Medicare Supplement Plans
The top Louisiana Medicare Supplement Plans are; Plan F, Plan G, and Plan N. These plans are offered through private insurance companies with the benefits covered under each letter plan being the same from one company to another. The only difference being that of premium costs.
For example, an individual seeking Plan F would receive the same benefits from any company, but the rates may be different for a variety of reasons such as age, sex, and location.
Plan F- First-Dollar Coverage
Plan F, also known as first-dollar coverage, is the most popular Medigap plan, as it leaves Medicare beneficiaries with minimal out-of-pocket expenses. For example, Plan F covers 100% of Medicare Part A deductibles as well as 100% of Part B deductibles. It also covers 100% of doctor fees that exceed the Medicare reimbursement rate, also known as excess charges.
Medicare Plan G
Plan G, also known as Medicare Part G, is the Medigap plan that has shown to have lowest rate increase from year to year. It also covers 100% of Medicare Part B excess charges. However, it does not cover your Part B deductible.
Cost Sharing Plan N
Plan N, also known as cost-sharing plan, does not cover as much as the aforementioned plans., However, Plan N can cost far less than Plan F and Plan G. It covers some of the expenses not covered by Medicare Part A and B but not all, such as Medicare Part B deductibles and excess charges.
Plan N does cover 100% of Medicare Part B coinsurance minus deductibles at up to $20 for office visits and $50 for emergency room visits. This plan may be most suitable for Medicare beneficiaries seeking to save money on the monthly premiums, as it offers the lowest monthly rates.
Louisiana Medicare Advantage Plan (Part C)
If you choose to enroll in Medicare Part C, also known as Medicare Advantage, it will take the place of Medicare Part A and B, and will result in your ineligibility to add a Medigap plan for additional coverage on medical expenses not covered under Part C.
Under Part C, Medicare recipients will only be able to see in-network hospitals and doctors (HMO’s and PPO’s).
The monthly premiums for Medicare Part C are usually lower than that of a Medigap plan. Where Medigap is beneficial is that they allow recipients to see any doctor and hospital of their choosing.
There are no networks, which can alleviate much stress and surprise out-of-pocket costs when learning that a previous Part C in-network doctor is no longer. Part C networks often change throughout year.
Louisiana Medicare Prescription Drug Plans (Part D)
Medicare Part D offers prescription drug coverage and can be added to Original Medicare (Part A and B) along with Medigap. There are four elements to the coverage under Plan D; deductibles, initial coverage, coverage gap, and catastrophic coverage.
Medicare beneficiaries may be responsible for paying deductibles on their Part D plan. Which is a monetary amount that is the beneficiary’s responsibility to pay prior to their coverage beginning to pay any of the expense.
Medicare Part D initial coverage covers 75% of prescription medications with the beneficiary being responsible for the remaining 25% of the costs. However, there is a cap as to the amount that the initial coverage will pay. The maximum amount that Medicare Part D initial coverage will pay in Louisiana for 2018 is $3,750, after that the beneficiary’s coverage gap will begin.
Coverage gap, also known as Medicare donut hole, covers a percentage of the cost for generic prescriptions and name brand prescription medications. With the brand name manufacturer providing a discount on the medications.
The coverage gap will end once the beneficiary reached the threshold. The 2018 coverage gap threshold for Louisiana is $5,000. Once the threshold is reached catastrophic coverage will begin.
Catastrophic Coverage will cover 95% of prescription medication costs with the remaining 5% of the costs being the responsibility of the Medicare Part D recipient.
It is important to enroll in Medicare Part D coverage as soon as you are eligible, as there are financial penalties for late enrollment. These penalties are calculated at a rate of 1% of the national base Medicare beneficiary premium multiplied by the number of months you went without Medicare Part D coverage after you became eligible. The financial penalty will automatically be deducted from you Social Security benefits for life.
There are many ways in which you can request further information and sign-up for a Louisiana Medicare Supplement plans. You can request quotes, apply online or over the phone, whichever method is most convenient for you.
Medicare Resources in Louisiana
- The Senior Health Insurance Information Program (SHIIP)
- Medicare Savings Program
FAQs People are Asking in Louisiana About Medicare
Does Medicare pay for nursing homes in Louisiana?
There are two types of nursing home care; custodial care and skilled nursing care. Medicare does not cover custodial care in Louisiana, but does cover skilled nursing care for up to a period of 100 days following a hospital stay of at least 3 days.
Where can I compare Louisiana Medicare Supplement Plans?
You can compare Louisiana Medicare Supplement Plans by completing our form online or by calling the number above to speak with one of our agents who can then provide you with rates from the top insurance companies in your area.
Does Medicare cover memory care in New Orleans?
Memory care is a distinct form of long-term skilled nursing care that is, unfortunately, not covered under Medicare in New Orleans or any other city. Medicare will continue to cover medical services while a beneficiary is in memory care, but Medicare will not cover the long-term non-medical residency of memory care.
Louisiana Medicare Health Coverage
Medicare provides health care coverage for seniors 65 or older along with those who are disabled, but Medicare does not cover 100% of medical costs. The best option for seniors to have the most complete coverage, and to alleviate the most out-of-pocket expenses, is to have Medigap in addition to their Original Medicare coverage.
To gain more information on Medigap plans in Louisiana, you may contact us by phone at the number above to speak with one of our agents. Or you can complete our rate comparison form online and an agent will then compare rates with the top carriers in your area.