Learn more about Medicare, such as eligibility, the different Medicare Parts, and how this can help you if you are a Louisiana resident.
Medicare in the United States is a social insurance program that is administered by the U.S. federal government. This program pays for hospital and medical care for elderly and certain disabled citizens. Medicare consists of two main parts for hospital and medical insurance (Part A and Part B), and two parts that provide flexibility and prescription drugs (Part C and Part D).
Louisiana residents who meet the criteria for eligibility should consider applying for Medicare.
Who is Eligible?
In order to be eligible for Medicare, applicants must be at least 65 years old, under 65 and disabled, or any age with End-Stage Renal Disease. In addition to these, an applicant must also be a U.S. citizen or permanent legal resident for 5 continuous years and is eligible for Social Security benefits with at least 10 years of payments into the system.
Part A and Part B
Medicare Part A is also referred to as Hospital Insurance or HI. This program helps pay for hospitalizations, including meals, supplies, testing, and a semi-private room. Home health care is also included in this part of the program, such as physical, occupational, and speech therapy that is deemed medically necessary and provided on a part-time basis. Part A also covers care in a skilled nursing facility and certain medical equipment such as walkers and wheelchairs.
Payroll taxes are used to cover the costs of Medicare Part A, so this is generally available without incurring monthly premiums.
Medicare Part B is also referred to as Supplementary Medical Insurance or SMI. This program covers physician visits, outpatient hospital visits, home health care costs. Some examples of the services that Part B covers for the aged and disabled are:
- Durable medical equipment (canes, walkers, wheelchairs, etc.)
- Physician and nursing services
- X-ray, laboratory and diagnostic tests
- Certain vaccinations
- Blood transfusions
- Renal dialysis
- Outpatient hospital procedures
- Some ambulance transportation
- Immunosuppressive drugs after organ transplants
- Certain hormonal treatments
- Prosthetic devices and eyeglasses
Medicare Part B requires a premium, and in addition requires patients to meet an annual deductible before coverage can begin. Enrollment in Part B is voluntary; however, if you decide not to enroll when you first become eligible for Medicare, you may have to pay a late enrollment penalty.
Part C and Part D
Medicare Part C is also known as Medicare Advantage and allows members to customize a plan that can meet their needs better. Part C can help cover the costs of services provided by hospitals, doctors, lab tests, and some preventive screenings by enlisting private insurance to provide some of the coverage; however the details of the coverage may vary depending on the program and the patient’s eligibility.
Medicare Part D is also known as the Prescription Drug Plan. This is administered by one of several insurance companies, each offering a plan that entails different costs as well as consists of different lists of drugs that are covered in the plan. Patients must pay a premium and deductible in order to participate in Medicare Part D.
Louisiana Medicare Savings Programs
Louisiana residents in need of financial assistance with some of their medical costs can avail of discounts. Residents must have an income that is below a certain limit in order to qualify for a Louisiana Medicare Savings Program.
Louisiana State Health Insurance Counseling and Assistance Program (SHIP)
Seniors in Louisiana can obtain counseling on various topics like Medicare claims and the Medicare appeals process through the Senior Health Insurance Information Program or SHIIP.