If you’re a Medicare beneficiary living in Louisiana, you can get help paying for your prescription drug expenses through Medicare Part D. Each Medicare Part D prescription drug plan in Louisiana may have different cost, depending on your place of residence and zip code, but most plans require you to pay a monthly premium, annual deductible, and copayment or coinsurance. Learn about Medicare Part D in Louisiana, and get help choosing a drug plan that works for your individual needs.
Medicare Part D is government-sponsored prescription drug coverage available to Medicare beneficiaries already enrolled, or eligible to enroll, in Original Medicare, Part A and Part B. In Louisiana, you can receive Medicare Part D benefits if you’re enrolled in certain types of Medicare Advantage (Medicare Part C) plans, a stand-alone Medicare Part D prescription drug plan, or a Medicare Supplement plan (Medigap).
Each Medicare Part D prescription drug plan in Louisiana has its own list of covered prescription drugs, called a formulary. The formulary divides drugs into tiers, which are different categories, each with a different cost. The highest tier includes the more expensive prescription drugs, while the lowest tier lists the lower-priced medications. If your doctor or health-care provider decides that a drug in a higher tier is medically necessary to treat your health condition instead of a similar drug in a lower tier, you or your prescriber can ask your plan for a
tiering exception to get lower cost-sharing for a higher tier medication.
In general, Medicare Part D drug plans in Louisiana let you choose between brand-name drugs and generic drugs. Generic drugs, as described by the Food and Drug Administration, are required to have the same active ingredients, strength, dosage, route of administration, and be proven to perform the same as brand-name drugs. The difference for you is that generic drugs often cost less than the brand-name versions, resulting in lower out-of-pocket expenses. If a generic prescription drug is not available, your drug plan may let you substitute it with a similar generic drug rather than paying more for a brand-name drug, so be sure to discuss all medication options with your physician.
You can join Medicare Part D in Louisiana during your Medicare Initial Enrollment Period, which begins three months before you turn 65, ends four months after that date, and always includes your birthday month. You must also either have or be eligible to join Medicare Part A and/or Medicare Part B to sign up for Medicare Part D.
You may also join Medicare Part D in Louisiana during the annual Open Election Period, which runs from October 15 to December 7, and you may switch Medicare Part D plans during that same period. If you’re enrolled in a Medicare Advantage plan in Louisiana and decide to switch back to Original Medicare, Part A and Part B, you may switch plans during the annual Medicare Advantage Disenrollment Period, which runs from January 1 to February 14. You then have until February 14 to add a Medicare Part D prescription drug plan to your coverage.
If you’re enrolled in Medicare due to a disability, you can join Medicare Part D in Louisiana from three months before until three months after your 25th month of disability.
Note that if you remain without creditable drug coverage for 63 days or more after your Initial Enrollment Period ends, you may be subject to a late-enrollment penalty for Medicare Part D in Louisiana for as long as you remain enrolled in Medicare. The penalty is calculated using 1% of the national base beneficiary premium, and the number of full months you were eligible for Medicare Part D but didn’t join. This amount is then added to your Medicare Part D monthly premium. The national base beneficiary premium may increase each year, which means your penalty fee may also increase annually.
There are many prescription drug plan options available through Medicare Part D in Louisiana. A Medicare Part D prescription drug plan is a stand-alone plan that Medicare beneficiaries can add to Original Medicare, Part A and Part B, to help cover costs for prescription drugs, while a Medicare Advantage Prescription Drug (MAPD) plan combines health and prescription drug coverage into a single plan. An MAPD plan offers at least the same coverage as Original Medicare, and sometimes includes extra benefits like vision, hearing, and dental, all for a single premium.
When comparing Medicare Part D prescription drug plans in Louisiana, it’s smart to take into consideration your personal prescription drug needs, since it’s your drug cost – rather than your premiums or deductibles -that usually determines your total out-of-pocket expenses.
It’s also a good idea to review your Medicare Part D plan at the end of each year to see if there were any changes to your coverage. Medicare Part D prescription drug plans in Louisiana and the rest of the United States are allowed to change their premiums, copayments, deductibles, and drug formularies every year, meaning that your current plan may not suit your health and budget requirements in the coming year.
Medicare Part D plan availability and costs vary by state. Here are some statistics on stand-alone Medicare Part D prescription drug plans in Louisiana (this information is subject to change):
Access the following resources for additional details about Medicare in Louisiana: