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Louisiana Health Insurance

Louisiana Health Insurance

When shopping for health insurance in the state of Louisiana there are several things to keep in mind.Whether you can buy an individual health insurance policy may depend on your health status, the type of coverage you want to buy, and other circumstances such as pre-existing conditions. If you are not receiving benefits through your employer, are you healthy enough to obtain health insurance in the individual market? If you are eligible to obtain health insurance in the individual market, Health Plan One can help you compare plans and prices appropriate for your health insurance needs. What if you are self employed or own your own business? Health Plan One can also assist small business owners in obtaining small group coverage. Do you have any pre-existing conditions, disabilities, or are you below an income level which could qualify you for free or low-cost health care programs offered by the government? You may be eligible in Louisiana for Medicaid, high risk pool, or LaCHIP. Eligibility requirements for each of these options are available on this page.

What Every Louisiana Resident Should Know About Health Insurance

The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not subject to medical underwriting, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.

Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes.

It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.

What If I'm Between Jobs?

As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.

With individual coverage, you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Louisiana so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Louisiana each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months. In Louisiana, medical underwriting is allowed without restriction which is the process a health insurance company goes through to assess the health status of individuals and use such information to determine if the insurance company wants to accept an application. Regarding pre-existing conditions, Louisiana health insurance companies can review your medical history for the last 12 months before coverage begins. If a pre-existing condition does exist, the health insurance coverage can be excluded for up to 12 months.

If you're healthy and are between jobs, are unhappy with the health insurance offered by your employer, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat or toll-free at (877) 567-5267 to answer any questions.

If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.

Small Group Plans

If you are self-employed, you could qualify for a small group plan in Indiana. You must have 2 or more eligible employees who each work at least 30 hours (this number varies by carrier). There is no standard amount of time in business required prior to applying for coverage. All carriers in Louisiana do medically underwrite for small group plans. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling. Health Plan One can help you by quoting plans for small groups. Simply call us at (877) 567-5267. Health Plan One can help you by quoting plans small groups. Simply call our toll-free number at (877) 567-5267.

Visit our Louisiana Small Business Group page for more information.

Medicaid in Louisiana

Another health insurance option you have is to see whether you qualify for the Medicaid program. Louisiana's Medicaid Program provides medical coverage for needy Louisiana residents who qualify. The Medicaid programs works like any other insurance coverage in many ways. Medicaid pays health insurance providers for covered services after all other medical insurances, including Medicare, have been paid. A Medical Eligibility Card is issued to eligible individuals and allows you to receive medical services from a provider if:

  • You are Medicaid eligible on the date the service is received, and
  • the services is offered by the Medicaid Program, and
  • the provider accepts Medicaid, and
  • the provider agrees to bill Medicaid for the service

In order to determine if you are eligible for Medicaid, you must meet the following criteria. If you receive Supplemental Security Income from the Social Security Administration, you are automatically eligible for Medicaid. Families who get help from the Office of Family Support are also eligible for Medicaid. Any individuals who do not receive assistance from the above programs may qualify for Medicaid if the individual or family is aged 65 or older, or if they have corrected vision no better than 20/200, or individuals who are or families with a pregnant member, a child under the age of 18 deprived of the support of at least one parent, a child under age 19, or a woman who needs treatment for breast or cervical cancer. Disabled individuals who meet SSA's disability criteria are also eligible for Medicaid.

Louisiana's Medicaid program covers many of the same services that private health insurance programs cover such as dental, physician services, family planning, chiropractic care, eye care, hearing, and home health. Other services include hospice, hospital services such as inpatient and outpatient services and emergency room care, immunizations, lab work, medical transportation, mental health, and occupational therapy services. Pregnancy, prescription drugs, physical therapy, rehabilitation clinic services, and x-rays are among services also provided.

To learn more about Louisiana's Medicaid program, please visit http://www.dhh.louisiana.gov/offices/?ID=92

For information on Louisiana Medicare, visit MedicareSolutions.com

Louisiana High Risk Pool

Another option is to see if you qualify for Louisiana's high risk pool called the Louisiana Health Plan. In order to qualify for the state's high risk health insurance you:

  • Cannot be eligible for Medicaid, Medicare, group health insurance coverage, or individual health insurance coverage
  • Must have two written denials of coverage due to preexisting conditions or a condition denied by an insurance company or agent

Unfortunately enrollment is limited in the High Risk Health Insurance Pool and you may be waitlisted or denied due to an overwhelming amount of applicants.

Services covered under the Louisiana Health Plan include a $500,000 maximum benefit per lifetime, $100,000 maximum benefit per calendar year, $15,000 maximum benefit for prescription drugs per calendar year, and $100,000 maximum benefit for transplants per lifetime. Most benefits cover services such as physician services, hospital, tests and x-rays, labs, prescriptions, and therapies. If you have a preexisting condition, there is a 6 month waiting period.

There are four deductible options to choose from under the Louisiana Health Plan. Plans A-D have deductibles that range from $1,000 to $5,000. Monthly premiums can range from $91.43 to $1,459.41 depending on the area and the age of the applicant.

To learn more about the Louisiana Health Plan, visit http://www.lahealthplan.org/index.html

Women's Health Programs

Louisiana Breast and Cervical Health Program provides quality breast and cervical early detection services to uninsured or underinsured low and moderate income Louisiana women aged 40 and over at no cost. LBCHP is part of the Center for Disease Control and Prevention's (CDC) National Breast and Cervical Cancer Early Detection Program. LBCHP was established in 2002 and operates in Greater New Orleans, Greater Baton Rouge, River Region, Southwest Louisiana, Northwest Louisiana, and Northeast Louisiana.

In order to qualify a women must meet the age, income, and insurance status requirements. For women between the ages of 40-49, early detection services include pelvic examination, Pap test, and clinical breast exam. For women 50-64, services include pelvic examination, Pap test, clinical breast exam, and mammogram. For a women to meet the income requirements, maximum allowable income must be at or below 250% of the federal poverty level. For example, a family of four must have an annual income at or below $55,125 and a monthly income at or below $4,594.

To learn more about the Louisiana Breast and Cervical Health Program, please visit http://labchp.lsuhsc.edu/ or call Toll-Free at 1.888.599.1073.