More Plan Options
The average Louisiana senior compares three or more plan options before making an enrollment decision.
Changes to 2021 Medicare Part D in Louisiana
People with Medicare benefits in Louisiana have more Medicare Part D Plan (PDP) choices in 2021. However, the standard initial deductible is now $445, up from $435 last year, a $20 increase over last years' standard deductible. The Initial Coverage Limit has increased to $4,130, a $110 bump over last year.
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.
Evaluate Part D Medicare plans wisely. If you have a regular prescription or two, we suggest that you verify that the plan you want offers your medication(s) at a good price. You find this information in the formulary. We post links to the formulary and pharmacy web pages, as well as the plan's phone number, on each of the PDP pages listed above.
IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health and your finances.
Did you Know Most Louisiana Medicare Advantage Plans Include Prescription Drug Coverage?
Your Medicare benefits are flexible, and there's more than one way to get prescription drug coverage. If you want to keep your Original Medicare, you can enroll in one of the stand-alone Medicare Prescription Drug Plans listed above. The other way to get Part D is by enrolling in one of the Louisiana Medicare Advantage Plans that include prescription coverage.
Using Supplement Insurance with Medicare Part D
Thinking about supplemental insurance that can offer you more coverage? It's a smart move. Even with the new health care law, Medicare only covers 80 percent of the hospital and doctor bills incurred by most seniors in the great state of Louisiana, leaving you to handle the rest. We make it easy to find the lowest price on the Louisiana Medicare Supplement, commonly called a Medigap plan, you want. The choice is yours, because all Medicare Part D plans are compatible with Louisiana Medigap plans.
Medicare Part D for Dual Eligible People in Louisiana
In Louisiana, if you are eligible for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) you will automatically be enrolled in a Louisiana Medicare Prescription Drug Plan and the Social Security Extra Help program. Extra Help pays for most of the costs of your prescriptions if you meet the eligibility requirements. You may also enroll in a plan of your own choosing that better meets your needs. If you qualified for Medicaid before you were eligible for Medicare, contact your local Medicaid office.
Frequently Asked Questions About Louisiana Medicare Part D Plans
Best plan is based on your regular prescriptions, cost, the pharmacy you use, and customer care provided by the plan. We recommend comparing these plans:
The average cost of a Medicare Part D plan in 2021 is about $32. Be aware, though, that this figure is slightly different depending on where you live. The good news is that basic plans start near $20 per month. To check out your options in Louisiana, browse to this page.
You can find all of the 2021 Medicare Part D plan information for Louisiana right here. You can compare plans, including monthly premiums, deductibles, copays, and 5-star ratings.
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.