Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare beneficiaries looking for an alternate way to get their Medicare Parts A and B can turn to Medicare Advantage, sometimes called Medicare Part C. Medicare Advantage plans, or MA plans, differ from Original Medicare in several ways but still provide the same level of coverage as the traditional program. While the federal government operates Original Medicare through the Centers for Medicare and Medicaid Services, private insurance firms provide Medicare Advantage plans. Private insurers must be approved by Medicare and follow its rules but have their own provider networks and rules regarding in-network and out-of-network coverage. Therefore, MA plan participants may be limited to seeing providers within the plan’s network. Original Medicare recipients can go to any doctor or hospital that accepts Medicare nationwide.
Over 880,000 Louisiana residents were Medicare recipients in 2020, with more than 360,000 of them choosing Medicare Advantage plans over Original Medicare. This number translates to about 41% of participants, which is slightly higher than the nationwide average of 38%. By 2021, the percentage of Medicare beneficiaries enrolled in MA plans reached 46%. Louisiana recorded more than 892,000 individuals with Medicare coverage in 2022 and about 50.6% had a Medicare Advantage plan. The average monthly MA premium increased by less than 1%, from $14.40 in 2021 to $14.53 in 2022 in Louisiana. Plan participants had 102 MA plans to choose from in 2022 compared to 94 in 2021.
This guide provides a thorough breakdown of Louisiana’s Medicare Advantage plans, including details on what’s covered under Medicare Advantage and how these plans work. It also offers a list of top MA plan providers in the state, eligibility requirements and where to find and sign up for a plan.
The Top 10 Medicare Advantage Plans in Louisiana
Louisiana has multiple private insurance companies offering numerous Medicare Advantage plans with varying costs, network rules, flexibility and extra perks. Outlined below are the top 10 Medicare Advantage providers in the state based on their total enrollment. To calculate total enrollment, the enrollment numbers for all the plans offered by a single provider were added together. Because the popularity of a provider may partially hinge on affordability, the table also includes a range of costs attached based on the available plans.
To see how each provider measures up based on Medicare’s rankings, readers also have access to the providers’ Medicare star ratings. This rating system measures a plan’s performance combined with member satisfaction surveys. Relevant ratings help beneficiaries compare providers based on overall quality and performance. The data used was last updated in April 2022. Medicare recipients can visit Medicare.gov to get the latest information on Louisiana’s plans.
Vantage Health Plan
Blue Cross and Blue Shield of Louisiana HMO
Blue Cross and Blue Shield of Louisiana
Ochsner Health Plan
How Medicare Advantage Plans Work in Louisiana
Medicare Advantage offers a mixture of plans to meet various needs. However, not all types of plans are available everywhere. The most common types of plans are health maintenance organizations (HMOs). HMOs usually require members to receive their care from a provider within a network. Another common option is preferred provider organizations (PPOs). PPOs may have a network and allow members to receive care from non-network providers but usually at a higher monthly premium than HMOs. Some areas of Louisiana also may have access to private-fee-for-service plans and special needs plans. Read the descriptions below to learn more about each plan type.
What Medicare Advantage Plans Cover in Louisiana
Because Medicare Advantage takes the place of Original Medicare, its plans must cover the same things, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. Hospice care is not covered by Medicare Advantage, but remains covered under Medicare Part A. MA plans frequently offer extras that Original Medicare recipients won’t get with their plans. For example, most MA plans include prescription drug coverage, referred to as Medicare Part D. Original Medicare requires recipients to purchase separate Part D plans. MA plans generally have additional perks. More than 90% of MA plans nationwide offer vision, dental, hearing, telehealth and fitness benefits that traditional Medicare plans don’t include.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Durable Medical Equipment
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Louisiana
Eligibility for Medicare Advantage works essentially the same as for Original Medicare. Thus, applicants must be aged 65 or older or have a disability that qualifies them for Medicare at a younger age. Medicare recipients must have Medicare Part A and Part B and can’t have a Medigap plan to sign up for an MA plan. Applicants must be U.S. citizens or non-citizens lawfully in the country.
However, eligibility can vary based on plan type. HMOs and PPOs don’t usually have any special requirements beyond the standard Medicare prerequisites. In contrast, SNPs always have additional conditions a recipient must meet, which is why they’re called special needs plans. SNPs are still either HMO or PPO plan types but with extra requirements attached. No matter which type of plan a beneficiary qualifies for, they must sign up during the set enrollment periods detailed below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
Medicare Advantage Open Enrollment Period
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Louisiana
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Available through the Louisiana Department of Insurance, the Senior Health Insurance Information Program provides counseling services to Medicare beneficiaries throughout Louisiana from offices located all around the state. Trained counselors offer unbiased, one-on-one guidance over the phone or face-to-face for seniors and disabled persons with proof of state residency who have Medicare or will soon enroll in Medicare. SHIIP counselors help beneficiaries better understand Medicare coverage options and benefits to protect them from paying too much for medical care and prescription drugs. Medicare counseling is completely free and confidential. SHIIP counselors can also explain private insurance options to beneficiaries who find that Medicare doesn’t cover all their costs, but no one will ever try to sell anything to program participants.
To find out how to get counseling services through the SHIIP program or request an appointment, call 1-800-259-5300 or 1-800-259-5301, or search for a SHIIP office near you using the SHIIP Partners map.
The Governor’s Office of ElderlyAffairs serves as the focal point for Louisiana’s seniors as the State Agency on Aging and the administrator of the Older Americans Act program services. GOEA administers a broad range of statewide programs and services through its network of agencies, including 64 parish Councils on Aging and 36 Area Agencies on Aging. Agency services are intended to assist persons aged 60 and older at offices located in various parishes throughout the state, with an emphasis on low-income individuals. These offices assist seniors with a wide range of aging issues free of charge. Services include Medicare counseling to answer questions about Medicare coverage, simplify the eligibility process and assist with Medicare Part D selection.
Aging and Disability Resource Center and SenioRX Programs
To assist older adults and disabled individuals within the state of Louisiana, the GOEA has expanded the state’s Aging and Disability Resource Centers and SenioRX Programs to assist with the unmet needs of underserved community members. ADRC offices are located throughout the state, and each office serves multiple parishes or regions. Services are free of charge to anyone, regardless of age, ability or income. For Medicare-eligible seniors, ADRC provides annual Medicare checkups to ensure they’re getting all the benefits they desire. Benefits counselors are also available to assist with applications and offer free counseling for seniors and preretirees with questions about Medicare, Medicare Advantage, Medicare Supplement Insurance, Prescription Drug Plans and Medicaid.
The New Orleans Council on Aging administers the Aging and Disability Resource Center for the parishes of Orleans, Plaquemines and St. Bernard. The ADRC is a collaborative effort of the Administration for Community Living and the Centers for Medicare & Medicaid Services and offers counseling on Medicare and Medicaid enrollment. This is a free service that provides answers and guidance to seniors and adults with disabilities, including Medicare counseling, assistance with Part D selection, and advice about the Prescription Assistance Program available for anyone needing help paying for their medications and Medicare beneficiaries in the Part D coverage gap known as the donut hole.
For seniors living in the parishes of Bienville, Bossier, Caddo, Claiborne, DeSoto, Red River, Natchitoches, Sabine and Webster, the Caddo Council on Aging offers information and counseling on Medicare and long-term care options from its Shreveport office. Seniors age 60 or older or disabled adults age 21 or over can talk with trained counselors, free of charge, who help them navigate complex insurance programs and answer questions on Medicare coverages, benefits and so on. Counselors can also assist with filling out Medicare Part D applications and finding the best plan each year, and they help low-income individuals complete applications for discounted medicines from drug companies.
The Jefferson Council on Aging, located in Metairie, operates an Aging & Disability Resource Center for seniors and adults with disabilities who reside in Jefferson, St. Charles, St. James and St. John the Baptist Parishes. Trained counselors provide unbiased one-on-one health insurance counseling, including information on Medicare, Medicaid and other insurance issues. Medicare counseling includes assisting beneficiaries with issues concerning eligibility, enrollment, claims, appeals, fraud, prescription drug coverage, financial assistance for medicines due to a coverage gap or donut hole and other program elements. This ADRC also provides options and solutions regarding health care and disability coverage, resource referrals and advocacy.