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.
For many seniors living in Louisiana, Medicare provides the coverage they need to get access to the care they require. Medicare typically includes Plan A for hospital and medical facility visits and Plan B to cover doctors and medical supplies. Those who need prescription coverage have the option of adding Plan D, though this requires a separate monthly premium. For seniors who feel traditional Medicare doesn’t quite fit their needs, Medicare Advantage can be an excellent alternative. While original Medicare is offered through the federal government, Medicare Advantage can be obtained through private insurance providers, creating greater flexibility in coverage options. Even seniors already enrolled in Medicare can make the switch during the open or special enrollment period.
Medicare Advantage Plans are required to provide the same coverage offered through Medicare Plans A and B, but many offer additional benefits to remain competitive against other insurers. Prescription coverage is often included, and some may cover hearing, dental and vision care as well. For seniors on a budget, receiving these benefits under one premium can significantly reduce monthly expenses. However, most Medicare Advantage providers only offer coverage for in-network providers or facilities. These are often limited within the issuing state, so traveling enrollees may find they pay more overall if Medicare is needed on the road. Those covered through traditional Medicare are free to see any provider in the country who accepts Medicare.
In Louisiana, 54% of the more than 900,000 residents who are Medicare-eligible are enrolled in a Medicare Advantage Plan as of July 2023. This is 6% higher than the national average and marks a 7.56% increase in the percentage enrolled in April of 2022.
For more information on Medicare Advantage Plans, seniors can read through this guide to learn how the plans work, become familiar with some of the in-state providers and get information on choosing the right plan for their unique medical and financial situation.
The Top 10 Medicare Advantage Plans in Louisiana
Louisiana seniors interested in Medicare Advantage have many plans to choose from across several providers. This allows them to find a more customized fit when it comes to coverage for their health care needs. The 10 most popular plan providers are listed in the table below according to the number of enrollees across all Medicare Advantage Plans offered. Cost ranges cover the lowest and highest priced plans available, and all information has been updated as of July 2023. For more recent information and additional details about plans, seniors can check out Medicare.gov.
Name
Enrollment
Medicare Star Rating
Monthly Cost Range
Plan Types
Blue Cross Blue Shield of Michigan
190409
5
$0 – $0
HMO
BlueCross BlueShield of Tennessee
96471
5
$0 – $0
HMO
Humana
47597
3.5
$0 – $109
PPO, HMO
Aetna Medicare
32357
3.5
$0 – $17
PPO
Vantage Health Plan
17906
4.5
$0 – $220
HMO
Wellcare
15980
2
$0 – $31
PPO, HMO
Highmark Inc.
15404
4.5
$0 – $0
HMO
Blue Cross and Blue Shield of Louisiana
8012
4.5
$0 – $100
PPO
Peoples Health
3395
3.5
$0 – $0
PPO
Wellcare by Allwell
226
2.5
$0 – $0
HMO
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?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*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.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
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.
Contact the Governor’s Office of Elderly Affairs at 225-342-7100, or find your local Council on Aging or Area Agency on Aging to request assistance with your Medicare application.
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.
Contact the statewide Aging and Disability Resource Center at 1-877-340-9100 to find the agency near you, or search for a participating ADRC office in your area on the Louisiana Answers website.
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 personal assistance, place local calls to 504-827-7843 or call toll-free at 1-888-922-8522. You can also email [email protected] and receive a reply within two business days.
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.
To receive Medicare counseling at no charge to you, place local calls to 318-676-7900 or call 1-800-256-3003 toll-free. You can also email [email protected] for more information.
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.
For more information about the ADRC services available at Jefferson Council on Aging, call 504-207-4690. Those living out of the area may call toll-free at 1-800-635-1437.
