Louisiana is known for its crawfish, Mardi Gras, and preferring the term parishes to counties when dividing up their state. It also is home to some of the most diverse residents of the United States, with language hybrids such as Creole and Cajun spoken fluently in New Orleans and other regions of the unique Southern state. Residents of Louisiana are influenced by many countries and backgrounds, and create their own blends of lifestyle that are exclusive to the bayou region.
Louisianians have several options when deciding on health insurance. East Coast Health Insurance offers plans from Blue Cross Blue Shield of Louisiana, Coventry, Humana and UnitedHealth Care throughout your state. Plan types and company availability depends on where you live, as well as monthly premium rates. To get an accurate idea of what plans you have to choose from, enter your zip code below and get a quote. If you have any questions about health insurance, or need help deciding which plan is right for you and your family, call one of our licensed Louisiana brokers at 888 803 5917.
While we can’t blame some Louisianians for having a tradition of making delicious food that doesn’t exactly pass as nutritional value, and living in hot, sticky weather that at times may not lend itself to physical activity, the state can still make some effort to improve their health. Ranked by the UnitedHealth Foundation at number 48 in 2011, Louisiana is clearly one of the least healthy places to live in the country. Though the state has been consistently at the bottom over the past decade, there are still areas that should be taken more seriously. Almost 1.1 million adults in Louisiana are considered obese, and the number of diabetic adults has also increased to over 10% of the population.
Louisiana has one of the highest uninsured populations in the country, at over 17%. Smoking has decreased, but still remains one of the highest percentages of smokers in the nation at 22%. Public health funding is fairly good, so that gives Louisiana residents somewhat of a strength. Residents also are using pre-natal care early on a regular basis. To help the current state of health in Louisiana, it is essential for uninsured residents who can afford a plan to get a health plan. Having access to medical care is extremely important, as well as making lifestyle changes – which could mean boiling or grilling instead of deep-frying, and taking up a regular form of exercise. It’s worth the effort to live longer and have a healthy family.
Health Insurance Plans
Blue Cross Blue Shield of Louisiana
- POS plans are offered to Louisiana residents in five options, including no in-network deductible or a $1,000 in-network deductible. Copay levels vary with each plan, and on our site we have identified them by the amount you pay for a PCP visit, which can be $25, $30 or $35. Prescription drugs are also available for a copay, starting at $7 for generics. These plans have the same functionality as an HMO with copays and immediate benefits, but you have the option of using non-network care for 20% coinsurance on most services. POS plans are very cost effective and efficient, though they do not cover maternity care.
- Community Blue plans are point-of-service plans managed by HMO Louisiana, Inc. They have deductible options of $1,000 or $1,500 for individuals and $3,000 or $4,500 for families. These plans offer low copays on office visits, vision care, emergency room, urgent care and physical therapy before meeting the deductible. After the deductible has been met, your plan covers 80% of inpatient and outpatient services, home health care and high-tech imaging. Preventive care is covered as soon as your plan starts for no cost in-network. Some services will require a referral from your primary care doctor.
- PPO plans come in several types in Louisiana, including lower cost plans like Blue Value and Blue Select, and comprehensive plans like Blue Max. These plans give you access to the preferred network of providers for a discounted rate, or the option of using non-network care. All three types of plans have individual deductibles ranging from $500 to $5,000. Blue Value and Blue Select plans cover 80% of in-network medical services after deductible, while Blue Max plans have either 70% or 80% depending on the deductible you choose. Blue Value plans do not have prescription drug coverage, Blue Max plans have various copays, and Blue Select plans cover at 80% coinsurance for generics. Blue Value and Select plans also do not cover doctor’s office visits for illness or injury.
- Blue Saver plans are high deductible PPO plans with the option of opening a health savings account. Deductibles range from $1,200 to $5,500 for individuals, and $2,400 to $10,000 for families. After meeting the deductible, you pay 20% coinsurance or nothing at all for major medical services including lab tests, surgery, inpatient hospital care and doctor’s office visits. With a Blue Saver plan, you receive a wide array of benefits and the ability to save for future medical needs or use funds periodically to pay for qualified health care costs. Preventive care is covered at 100% when using network doctors and facilities.
- Spectrum plans offer comprehensive coverage and immediate benefits for a copayment. With a POS copay plan, you have access to the POS network, as well as non-network care for a slightly higher rate. These plans come in a variety of deductibles, and have low out-of-pocket costs. As soon as your plan starts, you can see an in-network provider for preventive care at no charge, which includes annual health exams, women’s health screenings, well child care and more. After you meet the deductible, most hospital, diagnostic and physician services are available for a small percentage of coinsurance. These plans are also available in a more limited Value option for greater savings.
- High Deductible Health Plans also have a large number of benefits and great coverage, some of which cover 100% after deductible, with the capability of opening an optional health savings account. With an HSA, you have more control over health care spending and also receive tax benefits as a result. HSA funds are only available for use with medical costs, such as paying for care until you meet your deductible. Preventive care is available through in-network providers as soon as your plan begins, covered in full. Major medical services are offered as well as prescription drugs and doctor’s office visits.
- Copay plans are available in Louisiana in three types: Copay 70, Copay 80 and Enhanced Copay 80. Depending on how much coverage you want and how much you want to pay, there is a convenient plan with predictable rates on doctor’s office visits, prescription drugs and urgent care to fit your budget, but be prepared for a high deductible and higher premiums. Enhanced Copay plans have deductibles of $1,000 and $2,500 for individuals, Copay 80 plans have $3,500 and $5,000, and Copay 70 has a range from $1,500 to $7,500. All plans cover preventive care in full, and after deductible you can receive inpatient and outpatient hospital care and testing for a percentage of coinsurance.
- 100% After Deductible plans provide coverage on every service from physician’s office visits to surgery and hospitalization for 100% coverage after you reach the deductible amount. Louisiana residents can choose from Value (with individual deductibles of $5,000, $7,000 or $10,000 for individuals), HSA 100 or Enhanced HSA 100 plans (with individual deductibles from $1,500 to $5,950). Enhanced HSA 100 and Value plans cover prescription drugs, while HSA 100 does not. HSA plans come with the opportunity of starting a health savings account for tax-advantaged funds to use on medical expenses.
- Copay plans offer the convenience of a group health plan with doctor’s office visits and prescriptions for a set price, but with the freedom of a PPO. You have the ability to use in-network or out-of-network physicians and facilities with Copay plans, though network services cost less. There are two options for Copay plans, Copay Select Value and Copay Select, which have deductibles ranging from $1,000 to $10,000. Value plans have less prescription options, but still provide 70% coverage on inpatient and outpatient care after deductible. Copay Select plans cover either 70, 80 or 100% after deductible. Both plans have a $35 copay for the first four doctor’s office visits and preventive care covered at 100%.
- High Deductible plans are available in Saver 80, Plan 80 and Plan 100 options in Louisiana, with a range of deductibles from $1,000 to $10,000 depending on the type you choose. Plan 100 plans offer coverage in full on a large number of medical services after you meet the deductible, while Plan 80 and Saver 80 require you pay 20% coinsurance. Saver 80 plans have a more limited set of benefits, but still cover a variety of inpatient and outpatient hospital services, excluding prescription coverage and office visits.
- Health Savings Account plans have a variety of covered services at either 70% or 100% after deductible and the ability to open an HSA for more control over health care finances. Using the health savings account, you can pay for certain medical services or save for the future with tax benefits. HSA 70 plans have individual deductibles ranging from $1,250 to $5,000, and HSA 100 plans have deductibles ranging from $2,500 to $5,000 for individuals. Both plan types offer preventive care at no cost with in-network providers, including well child care, annual health screenings and more.
Public Health Options
The state of Louisiana provides funding for various programs designed to help its low-income, uninsured residents of all ages. Medicaid is the leading public health care initiative for medical insurance coverage, offering plans for children, families, pregnant women, aged and disabled individuals and more. To find out more about income guidelines and other criteria for Medicaid, visit our Medicaid Eligibility by State page. For individuals with pre-existing conditions, the Pre-Existing Condition Insurance Program is also a government-funded health plan for individuals without insurance with certain medical needs. Other public health services include immunizations, nutritional assistance programs and disease prevention. For a full list of services, go to the Louisiana Department of Health & Hospitals page.
- Medicaid: a variety of affordable or free health plans for low-income Louisianians without insurance who qualify.
- Louisiana Neighborhood Place: public health clinics with several locations to provide state-funded health care services under one roof.
- Shots for Tots: immunizations for uninsured infants in Louisiana.
- Louisiana Commodity Supplemental Food Program: nutritional assistance for pregnant women, infants, new mothers, adults over 60 and children 6 and under with a low income.
Health Insurance Laws
Louisiana health insurance companies have certain laws in place to regulate their operation and how they can regard certain types of applicants. The underwriting process shows how costly and individual will be for an insurer to take on, and Louisiana insurers have several legal protections to keep their costs down. A pre-existing condition is defined by the prudent person standard, meaning anything a person has or could have sought medical treatment for in the past before they applied for a health plan.
Once qualified as a person with such a condition, insurers can either deny you coverage or accept you for a higher premium rate. Insurance companies in Louisiana can use exclusion periods with no time limit, which gives them the right to not pay to treat the pre-existing condition for any given length of months or years. Elimination riders are also permitted, which acts as a permanent exclusion period and never requires an insurer to cover such costs. However, if you change plans from one insurance company to a new one, you can use your old coverage as a credit towards the cost of care during an exclusion period.
There is another option for individuals who have pre-existing conditions, formed by the Affordable Care Act. Pre-Existing Condition Insurance Plans are run by the U.S. Department of Health and Human Services, and provide health care coverage to qualified adults in need of a low-cost health plan. These plans are temporary, as the new health care law will implement in 2014 that Louisiana insurers must accept all adults no matter what their health status may be. The use of elimination riders and exclusion periods will be made illegal at that point as well.
State health exchanges will also offer coverage to all individuals without discrimination. These will be put in place in the beginning of 2014, and offer essential benefits to all adults. Those who cannot afford coverage but do not qualify for Medicaid will be given a federal subsidy if they meet certain income requirements to help them pay for their health plan through an exchange or a private insurance company. Essential benefits include preventive care, maternity, mental health, and many other types of care deemed necessary for coverage by the ACA.
A law that helps residents of Louisiana keep their health insurance is HIPAA. Though mainly recognized for protecting patient information and creating an eligibility pool for Medicaid, this act also contains a provision called guaranteed renewability. This provision helps individuals who have insurance keep their coverage by making it illegal for an insurer to not renew the same plan after their term has ended. It is also illegal for an insurance company to terminate a person’s policy on the grounds of illness acquired after they have signed up for a plan. As long as the insured has been paying their premiums and other costs and not in violation of their plan agreement, insurers must allow the individual to keep their benefits.