Louisiana is full of good food, amazing outdoor recreation, and a host of celebrations you don’t want to miss. There’s a good reason so many Louisiana residents stay through their golden years.
However, if you’re getting close to age 65 or otherwise qualify for Medicare, you might have questions about how it works and how much it costs. Understanding your Medicare options, especially during the initial sign-up period, is vital so that you can get the coverage you need.
Let’s take a look at what you need to know about Medicare in Louisiana.
Medicare was created to provide health insurance to those who are less likely to have access to employer-provided care. That includes those 65 and older, along with disabled Americans and those with specific health conditions.
As a result, qualifying for Medicare is about being in one of these groups.
To qualify for Medicare coverage, you need to be a U.S. citizen or permanent resident who has lived in the US for at least five years, and one of the following conditions must also apply:
Once you qualify for Medicare, you may be automatically enrolled. However, you’ll only receive the default options, which are Original Medicare Part A (hospital coverage) and Part B (medical coverage).
If you want to add prescription drug coverage (Part D), Medigap, or opt for a Medicare Advantage plan, you’ll need to take steps to compare plans and enroll in coverage yourself. You can do this online or over the phone, and talking to a licensed agent can make a big difference.
Once you have coverage, you’ll be able to make changes during the annual enrollment period (AEP) between October 15 and December 7 each year.
How much you pay for Medicare will depend on the specific plan you choose.
For Original Medicare, there are three main types of coverage:
Part A is premium-free for most Americans. If you need inpatient hospital care, you’ll pay an annual deductible of $1,556 in 2022. There is coinsurance of $0 for days 1-60 of care in a year and $389 per day for days 61-90.
Part B has a monthly premium of $170.10 and an annual deductible of $233 in 2022. After the deductible, you’ll pay 20% of the Medicare-approved amount for medical services and Medicare will pay the rest. Part D will vary depending on the plan you choose. There will be a monthly premium, along with a deductible and copayment amounts for each prescription. You’ll want to compare plans to choose the right option for your needs.
Medicare Advantage, also known as Medicare Part C, is a full replacement plan for Original Medicare. More than four million people in Louisiana have a Medicare Advantage plan. It includes all the coverage you would get with Part A and B, along with additional benefits. For example, most plans include prescription drug coverage. You may also be able to get vision, dental, and other benefits.
Some Medicare Advantage plans have the same monthly premium as Medicare Part B. Others cost a bit more. You’ll want to compare plans to make sure you get the best coverage for the price.
The other important thing to look at with Advantage plans is the medical network. Like private insurance, Medicare Advantage may have limited provider networks and will be generally focused in your area. You might not be able to get non-emergency coverage outside the network, so be sure your preferred doctors and specialists are included.
This guide answered many of the most pressing questions about Medicare in Louisiana, but it’s common to have specific concerns related to your individual situation. We’re here to help. You can contact our licensed agents to get answers to your questions and compare plans so you get the coverage you need.