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Written by David Bynon [3], Medicare Analyst since 2012.  Last updated July 15, 2025

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Special Needs Plans
 » 
Louisiana
 » 
Caddo Parish
 » 
American Health Advantage of Louisiana

American Health Advantage of Louisiana (I-SNP) Plan Details for Caddo Parish, LA

Plan Basics | Costs | Drug Coverage | Star Rating | Contact

This page provides coverage and cost details for American Health Advantage of Louisiana’s H8492-001-0 Medicare SNP plan for 2025. Enrollment is subject to eligibility.

American Health Advantage of Louisiana logo, a registered trademark of American Health Advantage of Louisiana
CMS 2025 Rating: ☆☆☆☆☆*

*This plan is new and has not yet been rated by CMS.

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. The American Health Advantage of Louisiana logo is a registered trademark.[2] Its use by MedicareWire is strictly for editorial purposes. This is not a solicitation of insurance.

This private health insurance option offers all of the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may include additional benefits that Medicare Part A and Part B do not cover.

Individuals must meet all Institutional SNP qualification requirements to join this I-SNP plan.

American Health Advantage of Louisiana Basic Plan Details

Plan ID
H8492-001-0
Plan Type
HMO I-SNP
Plan Year
2025
Premium
$55.60/mo
Plus your Medicare Part B premium.
Health Plan Deductible
$0.00
Out-of-Pocket Maximum
9,350.00 /yr (in-network)
Part B Reduction
$0.00/mo
Drug Plan Benefit
Basic
$590.00 deductible
Supplemental Benefits
Vision, Hearing
Availability
Caddo Parish, LA
Insured By
American Health Advantage of Louisiana

Health Plan Out-of-Pocket Costs

The following table is a summary of the most common out-of-pocket costs you will incur if you join this American Health Advantage of Louisiana plan:

Doctor's Office Visits

Primary
$0 Copay
Specialist
20% Coinsurance

Emergency, Urgent, and Inpatient Hospital Coverage

Emergency room care
20% Coinsurance
Urgent care
20% Coinsurance
Ground ambulance
20% Coinsurance
Inpatient hospital care
Skilled Nursing Facility
$0.00 per day for days 1 through 20
$0.00 per day for days 21 and beyond

Foot Care

Foot Exams and Treatments (Medicare-covered)
20% Coinsurance
Routine Foot Care
$0 Copay

Chiropractic Care

Medicare-covered chiropractic
20% Coinsurance
Routine chiropractic
Not Covered

Mental Health Services

Outpatient individual therapy
20% Coinsurance
Outpatient group therapy
20% Coinsurance
Inpatient psychiatric hospital care

Rehabilitation Services

Physical therapy and speech and language therapy
20% Coinsurance
Prior Authorization Required
Occupational therapy
20% Coinsurance
Prior Authorization Required

Medical Equipment and Supplies

Diabetes supplies
$0 Copay
Prior Authorization Required
Durable medical equipment
20% Coinsurance
Prior Authorization Required
Prosthetics
20% Coinsurance

Diagnostics, Lab Services, and Imaging

Diagnostic radiology services
20% Coinsurance
Prior Authorization Required
Lab services
$0 Copay
Prior Authorization Required
Outpatient x-rays
20% Coinsurance
Prior Authorization Required
Diagnostic tests and procedures
20% Coinsurance
Prior Authorization Required

Medicare Part B Drugs

Chemotherapy
20% Coinsurance
Other Part B drugs (Medicare-covered)
20% Coinsurance

Dental Services

Medicare Covered Preventive Dental
20% Coinsurance
Oral exam
Not Covered
Dental x-rays
Not Covered
Cleaning
Not Covered
Periodontics
Not Covered
Endodontics
Not Covered
Restorative Services
Not Covered

Hearing Aids and Services

Fitting/evaluation
Covered
Limits may apply
Hearing aids
Not Covered
Hearing exam
Covered
Limits may apply

Vision Services

Medicare-covered eye exam
20% Coinsurance
Routine eye exam
$0 Copay
1 Every year
Eyewear benefits
None

Prescription Drug Costs & Benefits

American Health Advantage of Louisiana includes an basic benefit Medicare Part D plan (PDP). This simply means that the plan covers the minimum amount required by the Centers for Medicare & Medicaid Services, whereas enhanced benefit plans cover more.

Prescription Drug Premium with Extra Help

Extra Help is a Social Security program that helps people with limited income and resources lower or cut Part D costs. The following table outlines premium assistance details with Extra Help.

Premium Subsidy Details with Extra Help
Low Income Premium Subsidy: ${part_d_lips_amount}
Low Income Premium Subsidy CMS Pays: $55.60
Low Income Subsidy Premium: $0.00

If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.

Prescription Drug Deductible

The Medicare Part D annual deductible with this plan is $590.00. You must pay this amount at the pharmacy before American Health Advantage of Louisiana begins paying its share.

Prescription Drug Out-of-Pocket Costs

In addition to the plan's monthly premium and deductible, American Health Advantage of Louisiana has out-of-pocket costs you must pay when you pick up your prescriptions.

Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Cost data not available.
*The Part D deductible does not apply.

CMS 5-Star Rating Marks

Each year CMS rates Medicare Special Needs Plans in nine broad categories based on a 5-star system. The table below shows the quality ratings for this American Health Advantage of Louisiana plan.

CMS Star Ratings for Plan Performance Measures
CMS Measure Star Rating
2025 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines Not enough data available
Managing Chronic (Long Term) Conditions Not enough data available
Member Experience with Health Plan Not enough data available
Complaints and Changes in Plans Performance Not enough data available
Health Plan Customer Service Not enough data available
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan Not enough data available
Member Experience with the Drug Plan Not enough data available
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆

How to Qualify to Enroll in
American Health Advantage of Louisiana

To be eligible to enroll in American Health Advantage of Louisiana, you must meet three requirements:

  1. You are eligible for Medicare;
  2. You live in Caddo Parish (the plan’s service area); and
  3. You require the level of care provided in an institutionalized setting, such as a long-term care nursing facility, for 90 days or more.

If you live at home and require an equivalent level of skilled care, you may be eligible for an Institutional Equivalent Special Needs Plan (IE-SNP).

Before joining American Health Advantage of Louisiana, consider these questions:

  • Does the plan's provider network include my nursing home or home care provider?
  • What costs should I expect with my coverage (premiums, deductibles, copayments)?
  • Is there an annual limit on my out-of-pocket costs?
  • Will I be able to use my doctors? Are they in the plan's network?
  • Are the plan's in-network providers and facilities in convenient locations?
  • Does the plan provide coverage for services I receive from out-of-network providers?
  • Do I need a referral to see a specialist?
  • Are my medications on the Part D plan's formulary?
  • What special accommodations does the plan make for persons with disabilities?
  • What special language and cultural accommodations does the plan make?

Additional I-SNP Plan Options

Here are some additional Medicare SNP plans that might be worth reviewing:

  1. American Health Advantage of Louisiana

Contact Us About American Health Advantage of Louisiana

Helpful Links and Contact Information for American Health Advantage of Louisiana
Website: American Health Advantage of Louisiana Plan Page (opens in new tab)
Providers: American Health Advantage of Louisiana Providers Page (opens in new tab)
Formulary: American Health Advantage of Louisiana Formulary Page (opens in new tab)
Pharmacy: American Health Advantage of Louisiana Pharmacy Page (opens in new tab)
New Member Health Plan Help: (866)266-6010
New Member Health Plan TTY: (833)312-0046
New Member Part D Help: (866)266-6010
New Member Part D TTY Users: (833)312-0046

If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.

Health Plan Compatibility

Medicare Advantage Special Need Plans are not compatible with most other forms of health insurance. If you have Medicare Part A and/or Medicare Part B and join a SNP plan, you will be disenrolled from Original Medicare. You cannot simultaneously enroll in an SNP plan and Medicare Supplement Insurance.

With a D-SNP, members retain their existing Medicaid plan and benefits. Veterans who have VA Health Benefits may also be able to receive care at their local VA hospital.

Citations & References

  • American Health Advantage of Louisiana, http://la.amhealthplans.com, Last Accessed October 13, 2024
  • Medicaid.gov, "Medicaid & CHIP in Louisiana", Last Accessed October 1, 2024
  • CMS.gov, Landscape Source Files, Last Accessed October 2, 2024
  • CMS.gov, Medicare Part C & D Performance, Last Accessed October 2, 2024
  • CMS.gov, Plan Benefits Package, Last Accessed October 5, 2024

Research Note: This content is based on independent analysis of CMS data by David Bynon, Medicare analyst and founder of MedicareWire.

For details on how this plan was analyzed and constructed using CMS data, see our Medicare Plan Research Methodology.

Disclaimer: MedicareWire does not endorse or rank Medicare plans. Plan information is provided for educational and research purposes only and may not reflect the most current data available from CMS or the plan provider.

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On This Page

  • Introduction
  • Plan Basics
  • Download Summary of Benefits
  • Out-of-Pocket Costs
  • Supplemental Benefits
  • Prescription Benefits
  • Plan Rating Marks
  • Get Help

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[3]About the Author

David Bynon is a Medicare analyst, published author, and U.S. Navy veteran with over 40 years of experience in cryptology, cybersecurity, and healthcare systems. Since founding MedicareWire in 2012, he has delivered independent, data-driven Medicare research to help seniors make informed, confident decisions.

David is also the founder of TrustPublishing.com and the inventor of the Memory-First Publishing and Semantic Digest protocols.

Connect with David on LinkedIn or view his Amazon Author Profile. His latest book, Why Medicare Advantage Plans Are Bad, is available on Amazon.

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