The Louisiana Health Insurance Marketplace
Louisiana residents have access to a federally-run health insurance exchange that makes individual coverage more accessible and affordable. Created by the law best known as Obamacare, the trusted insurers of Louisiana provide reduced-cost health plans to individuals, families, and small businesses on the exchange. As coverage was previously hard to come by for many residents with conditions and lower income, uninsured residents can now obtain coverage from subsidized individual health plans. The Affordable Care Act makes it possible for individuals to shop for health plans through a “marketplace” where discounted, benefit-rich coverage is sold by private insurers. Obamacare also requires everyone to get insured by any plan for which you are eligible, and the marketplace is a connector to coverage for many Louisianans who couldn’t otherwise afford a private plan.
Health insurance companies on the marketplace must lower premiums and cost sharing with subsidies for those who are eligible. Many individuals applying for health plans on the Louisiana exchange qualify for reduced rates and medical expenses, including residents who earn between 100-400 percent of poverty. Marketplace plans guarantee coverage for certain types of services, known as essential health benefits, as well as reduced rates. Covered services such as maternity care, doctor’s office visits, prescription medications, and emergency room care are included in Obamacare’s mandatory benefit categories.
To qualify for subsidized exchange plans, you must be a U.S. citizen or legal resident without access to any other source of coverage, such as employer insurance, Medicaid, Medicare, or military benefits. While anyone can purchase coverage on the exchange, it’s best for those who earn up to 400 percent FPL and are currently uninsured.
For beneficial, low-cost insurance plans available to individuals, families and small businesses, shop the marketplace. If you need guidance with costs and coverage options, contact a licensed agent at 888 803 5917.
Each plan sold through the Louisiana marketplace for individuals falls under one of four “metallic” coverage tiers: bronze, silver, gold or platinum. These levels indicate how much your plan covers for qualified medical services and how much cost sharing you are responsible for. Bronze and silver plans are also more reasonable in terms of monthly premiums, while gold and platinum plans tend to be higher as they offer more coverage.
Healthy, young residents under 30 have access to catastrophic plans as a minimal, affordable alternative to the comprehensive plans. They don’t cover the majority of health care services, but only what you’re likely to use if you don’t visit the doctor often. It’s no charge to see a doctor up to four times per year and receive preventive services, and emergency room visits are subject to deductible. These plans cost less than bronze plans but cannot be subsidized. Use the cost comparison tool below to view estimates of your rates in your area.
Marketplace shoppers are offered financial assistance from the federal government if they earn between 100 and 400 percent of poverty. Lower income enrollees will receive the largest subsidies, which may include assistance for both monthly payments and medical costs. Those eligible for exchange plans in Louisiana earning between 100 and 250 percent of federal poverty qualify for a cost sharing subsidy to help pay for coinsurance, copays and deductibles. If you earn up to 400 percent of FPL, the government will provide you with a premium tax credit.
Premium tax credits are estimated by income and family size, and the cost of the second-cheapest silver plan in your area as a percentage of income. Based on income level, your premium share is determined as demonstrated in the table below. The remainder is paid for by the subsidy.
The Lousiana exchange consists of five health insurance companies who offer reduced-cost individual and small group policies. Depending where you live, you may find there are 1 to 3 companies to choose from. One aside of exchange plans is smaller provider networks, so you’ll want to check with any doctors you use that they’re included before you enroll. If your doctors are contracted with any exchange plans, let us know which plans they do accept, and we’ll help you find coverage. The following carriers sell plans on the marketplace in Lousiana. Contact an agent to find out which plans serve your area at 888 803 5917.\
- AAA Vantage Health Plan
- Blue Cross Blue Shield Louisiana
- HMO Louisiana
- Humana Health Benefit Plan of Louisiana, Inc.
- Louisiana Health Cooperative
Under the Obamacare law, each health plan on the exchange must cover ten categories of benefits, so policyholders have access to the essentials of care. Called essential health benefits (EHBs), the law requires insurers to pay for preventive services such as cancer screenings at 100 percent, and the other nine types of services at copay, coinsurance or deductible. As the ACA provides a broad definition of EHBs, please read the your plan’s schedule of benefits before receiving care to be sure a service is covered.
Essential Health Benefits include:
- Preventive, wellness, and chronic disease management services
- Emergency care
- Office visits
- Prescription medications
- Maternity and newborn care
- Laboratory tests
- Pediatric care, including dental and vision
- Mental health and substance abuse services, including behavioral health care
- Rehabilitative and habilitative services and devices
Small Business Health Options Program
The marketplace also offers products for small business owners through the Small Business Health Options Program (SHOP) with the potential for discounts. Small business owners in Louisiana can cover their workers for less than traditional small group plans if they have up to 25 full-time employees who make less than $50,000 per year each with the Small Business Health Care Tax Credit. SHOP plans are also available to employers with up to 49 workers, though larger businesses may not receive a subsidy. The most substantial tax credit awarded to small businesses covers 50 percent of the employer’s premium contribution, given to businesses with up to 10 workers with annual income up to $25,000 each.
How to Apply
You can apply for Louisiana marketplace plans by contacting a licensed insurance agent at 888.803.5917. If you prefer, you can locate a facility where navigators can help you use the Obamacare site, HealthCare.gov, to apply. You can also apply through the website on your own, but you may find speaking with a professional is helpful when looking to insure your health. The licensed agents at East Coast Health Insurance are knowledgeable in the Louisiana market — and can connect you with coverage on and off the exchange.
Compare Louisiana Marketplace Plans
Below is a cost comparison tool providing a closer look at the marketplace policies. These rates are calculated by average premiums released by insurers on the exchange. If you’re interested in one of the plans you find in your results, or for a more precise quote of exchange plans and subsidy eligibility, call an agent at 888 803 5917.
*The above disclaimer pertains to the creator of this comparison tool, not East Coast Health Insurance, a licensed broker of insurance products.