Affordable Health Insurance for 2023

Types of Health Insurance in Louisiana

Catastrophic

Low Cost, Basic Coverage

Catastrophic health insurance is inexpensive coverage that’s customized for need. Plans are typically oriented in 2 ways:
1. Inpatient (Hospitalization) - oriented more towards accidents, injuries, sickness, critical illness, & disease.
2. Outpatient - oriented more towards doctor visits, specialist visits, & pharmacy benefits.

Major Medical

Comprehensive, Conventional Coverage

Major Medical covers everyday needs like doctor visits and emergency needs like hospitalization. Originally it was “tax compliant” meaning it was mandatory to avoid tax penalties, however after 2019 tax penalties no longer apply. Since the Affordable Care Act passed in 2010 (more commonly referred to as “Obamacare” or “ACA”), many Major Medical providers left Louisiana. Major Medical can be the most expensive type of coverage because it covers “pre-existing conditions” & Maternity (which may be excluded with other forms of coverage). For people that are healthy, self-employed, don’t qualify for government assistance, or don’t need maternity coverage there may be less expensive alternatives. In Louisiana, it’s important to get Major Medical information from a licensed agent who’s actually in Louisiana. Many out-of-state websites offer limited benefit plans that are incorrectly branded as Major Medical. Acting locally will ensure that you get the most accurate information because local agents are strictly regulated by the Louisiana Department of Insurance.

Marketplace

Major Medical Coverage With Government Assistance

You may hear this type of coverage referred to as either, “Major Medical, Obamacare, Affordable Care Act, ACA, or Healthcare dot gov.” There can be slightly nuanced difference between each one of those terms, however in general those terms all refer to the same type of coverage. Marketplace is government subsidized Major Medical coverage through private insurers. In Louisiana, there are 3 Marketplace providers : Blue Cross Blue Shield & Ambetter Health (for Southern Louisiana) + Vantage Health (for North Louisiana). Among those providers, you’ll have various plans to choose from. Marketplace prices, plans & benefits are not set; rather, they can fluctuate based on one’s income. Our agency’s job is to help you qualify for the most government assistance possible & therefore the lowest possible monthly premium ($0 in many cases). Monthly premiums may be paid for via government assistance (called a subsidy), for which we help you qualify. The amount of monthly subsidy ranges based on one’s income. In some cases, plans are partially subsidized, and in other cases plans are fully subsidized (meaning “free health insurance”). Marketplace works best for people who either receive a large subsidy (typically earn an income between $17,774 - $25,760) and/or for people who have an expensive pre-existing health condition.

Marketplace plans are mostly enrolled during an annual window called Open Enrollment (November 1-December 15 each year). however we can help people enroll outside of open enrollment with a “Special Enrollment Period.” Typically a “Qualifying Life Event” makes it easiest to enroll year-round. Some examples of qualifying life events are loss of coverage, loss of a job, changing jobs, moving residences, having a child, getting married or divorced. So do not worry if you missed open enrollment; we can still help you qualify. Aside from special enrollment, there are also year-round coverage options outside of the Marketplace that don’t require any tax or income information.

Not all people who qualify for Marketplace elect to enroll. Reasons for seeking Marketplace Alternatives include: not wanting to disclose tax or income information, needing immediate coverage, political preference, and/or not qualifying for a large enough subsidy to offset cost (income above $25,760 may have less expensive or more viable options through the Private Market). Consult with one of our local agents to compare and contrast each type of coverage.

Short Term Health Insurance

An Affordable Type of Private Market Coverage

Short Term Health Insurance (also referred to as “Short Term Medical” or simply “Short Term”) is affordable health insurance in the Private Market designed for individuals, families, and/or small employer groups that do not qualify for large amounts of government assistance (like Medicaid or Obamacare). Years ago Short Term was used for short blocks of time (1 to 6 months), however recent industry changes allowed these plans to be structured as annual coverage (1 year, 2 year, or 3 year) that’s equipped with optional renewal each year. Therefore, despite the name, Short Term can now be structured as viable ongoing coverage. In annual terms, it works best for people who want an affordable, customizable option & usually for people who do not qualify for government assistance, people who want to enroll outside of “open enrollment,” people who do not want to disclose tax or income information, people who are self-employed or business owners).

Inherent in it’s design it also offers the flexibility to be structured as temporary coverage, meaning in actual “short terms,” it can work best for people who simply need temporary coverage (such as students, people in-between jobs, people who need an alternative to COBRA). Short Term can also work well for people who’s coverage through their employer is too expensive (typically for their dependents like wife and/or children). There are some differences in qualification criteria (mainly Maternity & Pre-Existing Conditions). These plans allow enrollment year-round; there’s no tax or income required, and there’s no open enrollment window (meaning you can apply year-round for next-day coverage). There are many providers, types of coverage/plans, & qualification factors to consider so the best way to learn more is to have one of our licensed agents customize a quote to fit your exact need & budget.

Group

Coverage for Businesses & Employer Groups

Since the Affordable Care Act passed in 2010, businesses & small employer groups have seen the largest price increases in the entire health insurance industry. Group coverage is typically the most expensive type of coverage because it is “rated up” in order to cover risk for a larger pool of insured. This can include larger premiums as well as coverage gaps in the form of deductible, coinsurance, or out-of-pocket max. There are some differences in coverage between large employer groups & small employer groups. Small employer groups (under 50 employees) typically have more options available such as more affordable alternatives in the private market. Our agents can provide a free cost savings analysis for your business. For a free group quote, we’d simply need a census form with basic information on each member such as the number of employees & dependents, each person’s age. For the most complete assessment/accurate price comparison (compared to your current group coverage), we’d need to assess each employee’s age, smoker status, zip code, and health. If you are a business owner or HR representative in need of a free group quote, simply reach out to us and ask for a Group Census Form. If you are an employee who needs a lower priced health insurance option than your current Group Coverage through your work, simply complete the “Get a Free Quote” form at the top of the page. Employees may also want to consider the Dependent Coverage section below.

Dependent Coverage

For an Employee’s Children & Spouse

Group Health Insurance is typically offered as an employee benefit through providers like Blue Cross Blue Shield, United Healthcare, Aetna, Cigna, Humana, Ambetter, & Vantage. Not every employer provides equal contribution towards an employee & their dependents (spouse & children). Employers often contribute 50% to 100% towards the employee’s coverage, however they may not offer a contribution towards an employee’s dependents. Many times it’s least expensive for an employee to keep their group coverage (if they receive a 50% to 100% contribution), but to explore less expensive dependent coverage options in the private market.

If your employer offers health insurance, but you feel that it’s too expensive each month, than its likely due to the high cost of dependent coverage. Group Health Insurance is more expensive by nature because its “rated up.” Many times, even with an employer contribution, employees are paying more than necessary. Contact us for a free quote for your dependents, and one of our licensed agents will provide a free comparison of your current coverage to affordable alternatives. Often your dependents can get better coverage for much lower cost each month. The younger a person is, then the more we can likely save them.

Supplemental

Private Market Coverage & Defined Benefits

Supplemental plans are an affordable private market type of coverage that provides fixed or defined benefits. Plan options are vast, and coverage can be virtually customized to fit a specific need. In general Supplemental coverage works best as an enhancement to other forms of coverage, but in some cases it can serve as a stand alone policy. Supplemental can be structured to cover everyday needs such as doctor visits or hospitalization. These plans are most commonly structured:

1. as a stand-alone policy for a defined benefit (like doctor visits, accidents, hospitalization, or critical illnesses).
2. to supplement or enhance one’s primary health coverage (like to eliminate or mitigate one’s deductible).

How To Qualify & Understanding Government Assistance

Generally, There are 3 Ways to Qualify (Based on Income or Health)

Income below 138% = Medicaid
Income between 138%-400% = Marketplace or Private Insurance
Income above 400% = Private Insurance

Each dollar amount = annual adjusted gross income for household
Size of household = number of people

How To Get Accurate Prices & Information

Where Is the Agency Located?
Finding accurate information online is hard. That’s why we’ve invested so much time into creating this website to educate people about health insurance & healthcare in Louisiana. The best way to get accurate information is to meet with or speak with a licensed agent in Louisiana. Independent local agents (like ours) are strictly regulated by the Louisiana Department of Insurance and must provide accurate information by law. “Shopping” locally will ensure you get accurate prices & the most accurate information possible; it will also ensure protection of your personal information. The number one most common consumer complaint in the health insurance industry relates to people who submit their information to other out-of-state websites, then they receive hundreds of unwanted phone calls because their information was sold. Conversely, an agency like ours has strict privacy standards and HIPAA compliance regulations. Meaning, confidentiality & integrity is guaranteed. We will not, can not swarm you with unwanted correspondence or calls. In fact, most of our quoting & enrolling process can be done remotely via email, phone, and/or text.

Is the Agency Independent?
All of our health insurance agents are “independent” which means we can help you with any provider, plan, or type of coverage. Conversely, many other agents & agencies are “captive” (meaning, they only provide information related to the one company they represent, or to which they are “captive”). For example, if you contact a provider directly for a quote, they’re only going to quote their product, and they typically won’t provide the least expensive quote. That is the inherent bias (or, limitation) in consulting with a “captive” agent or agency. Our agency is independent, and therefore structured differently. Our sole mission is to help Louisianans save the most amount of money possible & to help them qualify for the best coverage available.