More Plan Options
The average Louisiana senior compares three or more plan options before making an enrollment decision.
2021 Medicare Prescription Drug Plan Changes in Louisiana
Louisiana seniors, you have more Medicare Part D plan (PDP) choices this year. Also, you'll find 2021 plans with lower monthly premiums, however, the standard initial deductible is now $445 per year, a $10 increase over last year. This increase is offset by a higher Initial Coverage Limit, which increased to $4,130.
2021 Medicare Part D Standard Initial Deductible
The initial deductible is the amount that you pay before your Medicare Part D plan begins paying its share of the costs. So, if you enroll in a 2021 prescription drug plan with a standard initial deductible, you'll spend $10 more out-of-pocket in 2021 before coverage begins. Most Medicare Part D plans have an initial deductible, but many popular Medicare Part D plans exclude Tier 1 and Tier 2 drugs from the deductible, giving immediate coverage on most lower-cost medications.
2021 Medicare Part D Initial Coverage Limit (ICL)
The 2021 Initial Coverage Limit (ICL) is $4,130. The Coverage Gap (donut hole) starts when you reach the ICL and ends when you hit the out-of-pocket threshold, which is now $6,550. The Initial Coverage Limit marks the coverage gap entry point. You enter the coverage gap when the total negotiated retail value of your prescription drug purchases exceed your plan’s Initial Coverage Limit.
Will You Fall Into The 2021 Donut Hole?
An easy way to estimate if you will run out of coverage is to look at that average monthly cost of your medications. If your prescriptions have an average retail value of over $335 per month, you will enter the 2021 Donut Hole at some point in the year. This assumes that your current retail drug prices remaining stable.
The 2021 Donut Hole Discount is 75% for Generic Drugs
If you reach the 2021 Coverage Gap phase of your Part D coverage, the generic drug discount will be 75%. This means your generic drug costs in the Donut Hole will be 25% of your Part D plan's negotiated retail prices. What you pay counts towards your true out-of-pocket costs (This amount counts toward your TrOOP).
The 2021 Donut Hole Discount is 75% for Brand-Name MedicationsThe 2021 brand-name Coverage Gap discount remains the same at 75%. The pharmaceutical industry is responsible for picking up 70% of the cost of medications for beneficiaries in the Donut Hole. You get credit for 95% of the retail drug cost toward meeting your 2021 total out-of-pocket maximum or Donut Hole exit point.
Some plans offer additional gap coverage, so look for it on the plan information pages.
How Much Will You Spend To Exit The Donut Hole in 2021?
Your Total Out-of-Pocket Cost (TrOOP) threshold will increase to $6,550 in 2021. That's $200 more than the 2020 TrOOP limit of $6,350. TrOOP is the dollar amount you'll spend to get out of the Donut Hole or Coverage Gap and into your Medicare Part D plan's Catastrophic Coverage phase.
It's important to remember that TrOOP doesn't include your monthly premiums or over the counter purchases. Some plans offer additional gap coverage, so look for it on the plan information pages.
Choose from the available Part D Medicare plans carefully, and don't settle on a Part D plan until you know that your most expensive medications are covered at a price you can afford. This information is available in the plan's formulary. You'll find links to the formulary information, pharmacy information, and the customer service phone number on each PDP page (above).
CRITICAL: The best Medicare Part D Plans for you can only be determined by factoring in what you can afford, your regular prescriptions and your health. A bit of time spent on research will pay off in the long run.
Get Your Prescriptions and More with a Louisiana Medicare Advantage Plan
Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescriptions. The Medicare Prescription Drug Plans above work with Original Medicare. That's one way. But maybe you'd like even more benefits. That's where Louisiana Medicare Advantage Plans come in. Most offer Part D coverage.
Combining a Supplement and Medicare Part D Benefits
The new healthcare law did not change the coverage you get from Medicare for major medical. You are still responsible for paying the remaining 20 percent of all hospital and doctor bills. Even a brief hospital stay can cost you thousands. That's why we maintain a complete catalog of Louisiana Medicare Supplement Insurance, also known as Medigap. We make it easy to find the best price on the plan you want. All Medigap plans are 100% compatible with the Medicare Part D plans listed above.
Getting Medicare Part D with Louisiana Medicaid
If you meet the requirements for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) in Louisiana, you will automatically receive a Medicare Prescription Drug Plan, as well as Extra Help from Social Security. If you qualify for Extra Help, the program will cover most of the costs of your prescriptions. Even if you qualify, the dual eligible option may not suit your needs. In this case, enroll in the prescription drug plan of your choice. If you receive Medicaid now, call your local Medicaid office for assistance with your dual eligible benefits.
Frequently Asked Questions About Louisiana Medicare Part D Plans
What is best for you may not be best for someone else. It all has to do with where you live and your regular prescriptions. These are some of the top plans in 2021:
Medicare Part D plans adjust each year. For 2021 the average cost is around $32, but that varies slightly by location. To compare plans in Louisiana, which start around $20 per month, Louisiana, goto this page.
Medicare Part D plans change annually and they are different in each state. You can see all of the plans available in Louisiana on this page.
PDP Eligibility and Availability
You are eligible to enroll in a Louisiana PDP plan if:
- You are a resident of the state,
- You are enrolled in Medicare Part A and Medicare Part B, and
- You are age 65+ or have Medicare due to a qualifying disability.
All plans on this page are available to beneficiaries in New Orleans, Metairie, Baton Rouge, Shreveport, Lafayette, Lake Charles, Kenner, Bossier City, Monroe, Alexandria, and all rural areas of Louisiana.
Citations & Referencesmedicare.gov
- What Medicare Part D drug plans cover | Medicare https://www.medicare.gov/drug-coverage-part-d/what-medicare-part-d-drug-plans...
- Medicare.gov: the official U.S. government site for Medicare | Medicare https://www.medicare.gov/
- CMS 1696 | CMS http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS012207.htm...
- MACRA: MIPS & APMs | CMS https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instrumen...
- An Overview of the Medicare Part D Prescription Drug Benefit | KFF https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-pr...
- Medicare Part D: A First Look at Prescription Drug Plans in 2020 – Issue Brie... https://www.kff.org/report-section/medicare-part-d-a-first-look-at-prescripti...
- 10 Things to Know About Medicare Part D Coverage and Costs in 2019 | KFF https://www.kff.org/medicare/issue-brief/10-things-to-know-about-medicare-par...
- Home | State Health Insurance Assistance Programs https://www.shiptacenter.org/