In Louisiana, the average cost of health insurance premiums per month is $578, and this is among the highest in the nation. However, for some qualified beneficiaries, there is Medicare to provide more affordable health coverage. Louisiana Medicare insurance is a federally funded program that mostly benefits senior citizens over the age of 65, but some workers with disabilities may qualify as well.
The main coverage that beneficiaries receive comes from Original Medicare, which is made up of Medicare Part A and Part B. Medicare Part A covers hospital insurance, including inpatient care services. Medicare Part B is for medical treatments and supplies including preventive services.
For most beneficiaries, there is no premium needed for Medicare Part A, although some may have to pay if they have not received enough Social Security Credits to qualify for premium-free Medicare Part A. Medicare Part B does come with a premium depending on the income, with those who earn less than $85,000 a year paying only $134 a month.
However, both Medicare Part A and Medicare Part B may require payments for deductibles, coinsurance, and copayments as part of the out-of-pocket costs.
Medicare beneficiaries can also opt to obtain Medicare coverage from private carriers in Louisiana which have been approved by Medicare. These carriers can offer their Medicare Advantage Plans, which combine the coverage afforded by both Medicare Part A and Part B. In many cases, these plans offer an advantage as they provide coverage for even more services that are not covered by Original Medicare. These Medicare Advantage Plans are also known as Medicare Part C.
Others may choose to supplement their Original Medicare coverage with Medicare Part D. This type of plan covers the cost of prescription drugs, which can be considerably expensive for senior citizens with several medical issues.
Medicare Supplement Plans (MSP) can provide coverage for other medical services that are not part of Medicare Part A and Part B. Other supplemental plans can even cover the cost of deductibles and copayments required for Original Medicare.
The Louisiana state government runs a Medicaid program that can also help pay for Medicare premiums and other out-of-pocket expenses. To qualify, a beneficiary must have Medicare Part A, and their income and resources must be within qualifying limits.
The Qualified Medicare Beneficiary program (QMB) covers all the premiums for Medicare Parts A and B. It also pays for deductibles and copayments. To be eligible, an individual must earn less than $1025 a month. For couples, the income ceiling is $1374.
Louisiana also offers a program for Specified Low-Income Medicare Beneficiaries (SLMB), and this pays for the premium for Medicare Part B. To qualify, an individual’s monthly income must not exceed $1226, while the combined monthly income of a married couple should be less than $1644.
Another program that pays for Medicare Part B premiums is for Qualified Individuals. This time, the income limit for an individual is $1,377 a month. The combined income for married couples should be less than $1847 a month.
These MSPs have a resource limit as well. These resources include savings and checking accounts, bonds, and stocks. For individuals, resources cannot total more than $9,600 while married couples have a resource limit of $14,340.
Other beneficiaries may receive help in paying for Medicare Part D with the Extra Help program. To be eligible, an individual’s annual earnings should be less than $18,090 while resources cannot be worth more than $13,820. For married couples, the income limit is $24,360 per year with a resource limit of $27,600.
Qualified Disabled and Working Individuals may also receive coverage for Medicare Part A premiums. Individuals who qualify need to have an income of no more than $4,105 per month, while married couples need to have a combined monthly income of less than $5,499 per month.
With the numerous rules and qualifications regarding Medicare, it’s not surprising that many applicants and beneficiaries may have questions and issues regarding Medicare. However, the law requires states to have a State Health Insurance Program to answer all these questions. In Louisiana, this is called the Senior Health Insurance Information Program (SHIIP), which offers free and confidential counselling regarding Medicare rules and options.
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