Last Updated on April 11, 2026 by Edward Harris
Affordable health insurance in Louisiana is available to individuals, families, Seniors, self-employed persons, small businesses, and large businesses. The Federal Marketplace manages under-65 enrollment and provides Advance Premium Tax credits (APTC) that can substantially lower premiums, often reducing rates to $0. Cost-sharing reductions can also lower copays, deductibles, and coinsurance. More than 90% of all applicants qualify for rate reductions.
Five insurers offer 2026 ACA Marketplace plans in Louisiana. They are Ambetter, HMO Louisiana/ BCBS Of LA, UnitedHealthcare, AmeriHealth Caritas Louisiana, and CHRISTUS. Coverage (with premium tax credits) is typically offered to most legal residents that have not reached age 65, and are not eligible for Medicaid or Medicare. All counties have several available carriers, and no person can be denied coverage because of current or past medical history. Approved ACA rate changes are shown below. The Louisiana Department Of Insurance must review all requests.
2026 Louisiana ACA Rate Plan Changes
Ambetter – 23.11% increase
HMO Louisiana – 24.90% increase
Louisiana Health Service & Indemnity – 32.49% increase
UnitedHealthcare – 23.02% increase
Most Affordable Louisiana Health Insurance Plans
Bronze Tier
HMO Louisiana Community Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible – Two $0 pcp virtual visits from Quality Blue providers. $9,900 deductible with 10% coinsurance and $10,600 maximum out-of-pocket expenses. HSA-eligible.
HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible – Two $0 pcp virtual visits from Quality Blue providers. $9,900 deductible with 10% coinsurance and $10,600 maximum out-of-pocket expenses. HSA-eligible.
HMO Louisiana Community Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses. HSA-eligible.
HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses. HSA-eligible.
HMO Louisiana Precision Blue Copay (PCP) 50/50 $7500 Standardized (BR) HSA Eligible – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses. HSA-eligible.
HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses. HSA-eligible.
HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible – Two $0 pcp virtual visits from Quality Blue providers. $6,500 deductible with 40% coinsurance and $10,600 maximum out-of-pocket expenses. HSA-eligible.
Ambetter Standard Expanded Bronze – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses.
Ambetter Standard Expanded Bronze – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses.
Ambetter Everyday Bronze – $40 and $90 pcp and specialist office visit copays with $50 copay for Urgent Care visits. $3 and $40 preferred generic and generic drug copays. Tier, 2, Tier 3, and Tier 4 drug copays are 45% (subject to deductible). $8,450 deductible with 50% coinsurance and $10,150 maximum out-of-pocket expenses. $50 copay for lab and professional services.
Ambetter Elite Bronze – $60 and $120 pcp and specialist office visit copays with $65 copay for Urgent Care visits. $3 and $30 preferred generic and generic drug copays. Tier, 2, Tier 3, and Tier 4 drug copays are $195, 45%, and 50% (subject to deductible). $0 deductible with 50% coinsurance and $10,500 maximum out-of-pocket expenses. $65 copay for lab and professional services.
AmeriHealth Caritas Next Bronze Essential – $25 pcp copay for first four visits with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are subject to deductible. $10,600 deductible with 0% coinsurance and $10,600 maximum out-of-pocket expenses.
AmeriHealth Caritas Next Bronze Signature– $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $50, $100, and $150 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses.
Christus Value Bronze – Three $0 pcp office visits. $10,600 deductible with 0% coinsurance and $10,600 maximum out-of-pocket expenses.
Christus Standard Expanded Bronze – $50 and $100 pcp and specialist office visit copays with $75 copay for Urgent Care visits. $25 drug copay. Preferred brand and non-preferred brand drug copays are $50 and $100 (subject to deductible). $7,500 deductible with 50% coinsurance and $10,000 maximum out-of-pocket expenses.
UnitedHealthcare Bronze Essential – $10,600 deductible with 0% coinsurance and $10,600 maximum out-of-pocket expenses.
Silver Tier
Ambetter Standard Silver – $40 and $80 pcp and specialist office visit copays with $60 copay for Urgent Care visits. $20 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $40, $80, and $125 (Tier 2 not subject to deductible). $6,000 deductible with 40% coinsurance and $8,900 maximum out-of-pocket expenses.
Ambetter Focused Silver – $40 and $85 pcp and specialist office visit copays with $60 copay for Urgent Care visits. $3 and $15 preferred generic and generic drug copays. Tier, 2, Tier 3, and Tier 4 drug copays are $75, 45%, and 50% (Tier 2 not subject to deductible). $6,300 deductible with 50% coinsurance and $8,400 maximum out-of-pocket expenses. $50 copay for lab and professional services.
HMO Louisiana Community Blue 80/60 $3200 with 2 $0 PCP Virtual Visits – Two $0 pcp virtual visits from Quality Blue providers. $3,200 deductible with 20% coinsurance and $9,100 maximum out-of-pocket expenses.
HMO Louisiana Community Blue Copay (PCP) 60/40 $6000 Standardized – $40 and $80 pcp and specialist office visit copays with $60 copay for Urgent Care visits. $20 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $40, $80, and $125. $6,000 deductible with 40% coinsurance and $8,900 maximum out-of-pocket expenses.
HMO Louisiana Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits – Two $0 pcp virtual visits from Quality Blue providers. $3,200 deductible with 20% coinsurance and $9,100 maximum out-of-pocket expenses.
AmeriHealth Caritas Next Silver Essential – $25 and $70 pcp and specialist office visit copays with $45 copay for Urgent Care visits. $25 and $60 generic and preferred brand drug copays. Non-preferred brand and specialty drugs subject to deductible and coinsurance. $6,100 deductible with 35% coinsurance and $9,000 maximum out-of-pocket expenses.
Christus Standard Silver 70 – $40 and $80 pcp and specialist office visit copays with $60 copay for Urgent Care visits. $25 generic drug copay. Preferred brand and non-preferred brand drug copays are $40 and $80 (non-preferred brand subject to deductible). $6,000 deductible with 40% coinsurance and $8,900 maximum out-of-pocket expenses.
Christus Silver Essential 70 – $5 and $50 pcp and specialist office visit copays with $50 copay for Urgent Care visits. $0 and $10 generic drug copays. Preferred brand and non-preferred brand drug copays are $60 and $80 (non-preferred brand subject to deductible). $6,900 deductible with 50% coinsurance and $9,300 maximum out-of-pocket expenses. $60 copay for diagnostic tests and $400 copay for imaging.
Christus Standard Silver – $40 and $80 pcp and specialist office visit copays with $60 copay for Urgent Care visits. $20 generic drug copays. Preferred brand and non-preferred brand drug copays are $40 and $80 (non-preferred brand subject to deductible). $6,000 deductible with 40% coinsurance and $8,900 maximum out-of-pocket expenses. 40% coinsurance for diagnostic tests and $400 copay for imaging.
UnitedHealthcare Silver Value – $20 and $80 pcp and specialist office visit copays with $100 copay for Urgent Care visits. $0 and $10 generic drug copays. Preferred brand and non-preferred brand drug copays are $100 and 40%. $4,000 deductible with 40% coinsurance and $10,600 maximum out-of-pocket expenses. $15 copay for lab tests ($75 in hospital).
Gold Tier
Ambetter Standard Gold – $30 and $60 pcp and specialist office visit copays with $45 copay for Urgent Care visits. $15 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $30, $60, and $100. $2,000 deductible with 25% coinsurance and $8,300 maximum out-of-pocket expenses.
Ambetter Complete Gold – $15 and $35 pcp and specialist office visit copays with $35 copay for Urgent Care visits. $3 and $15 generic drug copays. Tier, 2, Tier 3, and Tier 4 drug copays are $30, 25%, and 30%. $1,450 deductible with 20% coinsurance and $7,600 maximum out-of-pocket expenses. $15 copay for lab and professional services.
Ambetter Elite Gold – $5 and $60 pcp and specialist office visit copays with $35 copay for Urgent Care visits. $3 and $15 generic drug copays. Tier, 2, Tier 3, and Tier 4 drug copays are $50, 45%, and 50%. $0 deductible with 30% coinsurance and $6,500 maximum out-of-pocket expenses. $15 copay for lab and professional services. $40 and $75 copays for lab and professional services, and x-rays and diagnostic images. $75 copay for imaging.
HMO Louisiana Signature Blue Copay (PCP) 75/55 $2000 Standardized – $30 and $60 pcp and specialist office visit copays with $45 copay for Urgent Care visits. $15 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $30, $60, and $100. $2,000 deductible with 25% coinsurance and $8,300 maximum out-of-pocket expenses.
HMO Louisiana Blue Connect Copay (PCP) 75/55 $2000 Standardized – $30 and $60 pcp and specialist office visit copays with $45 copay for Urgent Care visits. $15 generic drug copay. Tier, 2, Tier 3, and Tier 4 drug copays are $30, $60, and $100. $2,000 deductible with 25% coinsurance and $8,300 maximum out-of-pocket expenses.
HMO Louisiana Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits – $40 and $60 pcp and specialist office visit copays with $60 copay for Urgent Care visits. $7 generic drug copay. Two $0 pcp virtual visits from Quality Blue providers. $1,000 deductible with 20% coinsurance and $9,700 maximum out-of-pocket expenses.
AmeriHealth Caritas Next Gold Signature – $30 and $60 pcp and specialist office visit copays with $45 copay for Urgent Care visits. $15 and $30 generic and preferred brand drug copays. Non-preferred brand and specialty drugs have $60 and $100 copays. $2,000 deductible with 25% coinsurance and $8,300 maximum out-of-pocket expenses. Diagnostic tests and imaging subject to 25% coinsurance.
CHRISTUS Gold Essential – $5 and $35 pcp and specialist office visit copays with $35 copay for Urgent Care visits. $0, $10 and $50 preferred generic, generic, and preferred brand drug copays. Non-preferred brand and specialty drugs have $60 and $150 copays. $3,750 deductible with 30% coinsurance and $9,200 maximum out-of-pocket expenses. Diagnostic tests, lab tests, and imaging subject to $20, $30, and $200 copays.
CHRISTUS Standard Gold – $30 and $60 pcp and specialist office visit copays with $45 copay for Urgent Care visits. $15, $30 and $60 Generic, preferred brand drug, and non-preferred brand copays. Specialty drugs have $100 copays. $2,000 deductible with 20% coinsurance and $8,300 maximum out-of-pocket expenses. Diagnostic tests, lab tests, and imaging subject to coinsurance and deductible.
2026 Louisiana Health Insurance Rates (Under Age 65 Monthly Premiums) In Selected Areas
New Orleans Area
25-Year-Old With $27,000 Household Income
$0 – HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$13 – HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$17 – Ambetter Standard Expanded Bronze
$17 – Ambetter Everyday Bronze
$27 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$27 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$41 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$46 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$118 – Ambetter Standard Silver
35-Year-Old With $45,000 Household Income
$0 – HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$8 – HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$18 – Ambetter Standard Expanded Bronze
$19 – Ambetter Everyday Bronze
$41 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$42 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$75 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$88 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$264 – Ambetter Standard Silver
45-Year-Old Married Couple And One Child With $72,000 Household Income
$14 – HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$138 – HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$153 – Ambetter Standard Expanded Bronze
$154 – Ambetter Everyday Bronze
$187 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$188 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$238 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$257 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$521 – Ambetter Standard Silver
50-Year-Old Married Couple And Two Children With $85,000 Household Income
$0 – HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$22 – HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$44 – Ambetter Standard Expanded Bronze
$45 – Ambetter Everyday Bronze
$94 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$96 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$197 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$257 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$585 – Ambetter Standard Silver
Baton Rouge Area
30-Year-Old With $30,000 Household Income
$0 – HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$28 – HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$34 – Ambetter Standard Expanded Bronze
$34 – Ambetter Everyday Bronze
$45 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$46 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$53 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$57 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$154 – Ambetter Standard Silver
40-Year-Old With $40,000 Household Income
$99- HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$145- HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$151 – Ambetter Standard Expanded Bronze
$152- Ambetter Everyday Bronze
$164 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$164 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$172 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$177 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$287 – Ambetter Standard Silver
50-Year-Old Married Couple And One Child With $75,000 Household Income
$0 – HMO Louisiana Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible
$71- HMO Louisiana Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible
$94 – Ambetter Standard Expanded Bronze
$95- Ambetter Everyday Bronze
$138 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$139 – Ambetter Standard Everyday Bronze + Vision + Adult Dental
$167 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$185 – HMO Louisiana Blue POS 60/40 $6500 With 2 $0 PCP Virtual Visits HSA Eligible
$566 – Ambetter Standard Silver
Shreveport Area
35-Year-Old With $32,000 Household Income
$46 – Christus Value Bronze
$61 – Christus Value Bronze + Dental & Vision
$67 – Christus Standard Expanded Bronze
$77 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$83 – Ambetter Standard Expanded Bronze
$83 – Ambetter Everyday Bronze
$85 – Christus Bronze Essential
$94 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$179 – Christus Value Silver 73
45-Year-Old And One Child With $54,000 Household Income
$145 – Christus Value Bronze
$174 – Christus Value Bronze + Dental & Vision
$183 – Christus Standard Expanded Bronze
$203 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$212 – Ambetter Standard Expanded Bronze
$213 – Ambetter Everyday Bronze
$216 – Christus Bronze Essential
$233 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$387 – Christus Value Silver 73
55-Year-Old Married Couple And One Child With $76,000 Household Income
$20 – Christus Value Bronze
$88 – Christus Value Bronze + Dental & Vision
$112 – Christus Standard Expanded Bronze
$159 – HMO Louisiana Blue Connect Copay (PCP) 50/50 $7500 Standardized N HSA Eligible
$181 – Ambetter Standard Expanded Bronze
$183 – Ambetter Everyday Bronze
$189 – Christus Bronze Essential
$230 – Ambetter Standard Expanded Bronze + Vision + Adult Dental
$602 – Christus Value Silver 73
Note: Louisiana Medicaid is available through the Bureau of Health Services Financing. Applicants for ACA plans that are eligible for Medicaid, will not receive advance premium tax credits (APTC).
Louisiana Medicare Supplement Monthly Rates (Based on Female Age 65 In Shreveport Area)
Plan A
$86 – AARP-UnitedHealthcare
$104 – Cigna
$113 – Philadelphia American
$116 – Omaha Insurance
$117 – Physicians Select
$118 – United American
$124 – Insurance Company Of North America
$127 – Medico
$127 – Woodmen Of The World
$129 – American Benefit Life
$134 – Humana
$141 – Aetna
$145 – AFLAC
$167 – Bankers Fidelity
Plan F
$127 – Cigna
$144 – AFLAC
$145 – Medico
$154 – Woodmen Of The World
$157 – Physicians Select
$160 – American Benefit Life
$163 – Insurance Company Of North America
$168 – AARP – UnitedHealthcare
$183 – Humana
$191 – Cigna
$192 – Aetna
$193 – Philadelphia American
$212 – Bankers Fidelity
$244 – United American
Plan G (HD)
$33 – Philadelphia American
$34 – Bankers Fidelity
$39 – Aetna
$40 – Humana
$41 – Medico
$41 – United American
$42 – Cigna
$43 – Omaha Insurance
$43 – Bankers Fidelity
$44 – Woodmen Of The World
$46 – Insurance Company Of North America
$47 – Physicians Select
Plan G
$97 – Physicians Select
$101 – Bankers Fidelity
$106 – Cigna
$110 – Medico
$124 – AFLAC
$126 – Insurance Company Of North America
$128 – Woodmen Of The World
$130 – American Benefit Life
$169 – Aetna
$173 – Humana
$219 – United American
Plan N
$77 – Cigna
$78 – Bankers Fidelity
$85 – Medico
$88 – Philadelphia American Life
$89 – Insurance Company Of North America
$92 – AFLAC
$92 – Woodmen Of The World
$96 – American Benefit Life
$104 – Omaha Insurance
$106 – Humana
$112 – AARP-UnitedHealthcare
$113 – Aetna
$260 – United American
Louisiana Medicare Advantage Plans For 2026
New plans For 2026
Aetna Medicare Chronic Care
Aetna Medicare Full Dual Care
Aetna Medicare Signature Care
Aetna Medicare Signature Plus
AmeriHealth Caritas VIP Care
Blue adVantage Thrive
Blue adVantage Classic
DEVOTED CHOICE 005
DEVOTED DUAL CHOICE 004
DEVOTED CHOICE GIVEBACK 006
DEVOTED C-SNP CHOICE PLUS 014
DEVOTED C-SNP CHOICE PREMIUM 013
DEVOTED DUAL CHOICE FULL 015
Humana USAA Honor Giveback
Humana Gold Plus
Humana Value Plus
Lagniappe Advantage
Wellcare Giveback
Wellcare Patriot Giveback
Wellcare Dual Access
Wellcare Dual Liberty
Parishes With Most Available Plans
65 – East Baton Rouge
65 – Orleans
64 – Jefferson
62 – Ascension
62 – West Baton Rouge
60 – St. Charles
57 – St. Bernard
58 – Iberville
56 – Livingston
55 – East Feliciana
55 – St. Helena
55 – St. James
54 – Assumption
MA Plans Without Prescription Drug Coverage
Aetna Medicare Eagle Pus Giveback – $0 monthly premium with $6,750 maximum out-of-pocket expenses. 982 statewide members and 1,169 countrywide members. Plan Summary Star Rating is 4.5, and pcp/specialist visit copays are $0 and $0-$35. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0. Inpatient and outpatient hospital copays are $285 for days 1-8, and $0-$285 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $35. Hearing exam copay is $35 and routine vision copay is $0-$35.
Humana USAA Honor Giveback HMO – $0 monthly premium with $4,900 maximum out-of-pocket expenses. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $40. Diagnostic tests and procedure copay is $0-$50 and lab services copay is $0-$40. Inpatient and outpatient hospital copays are $225 for days 1-6, and $0-$250 per visit. The ground ambulance copay is $335 and the occupational therapy visit copay is $20. Hearing exam copay is $40 and routine vision copay is $0-$40.
Humana USAA Honor Giveback PPO – $0 monthly premium with $4,900 maximum out-of-pocket expenses. 405 statewide members and 7,397 countrywide members. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $35. Diagnostic tests and procedure copay is $0-$50 and lab services copay is $0-$40. Inpatient and outpatient hospital copays are $210 for days 1-6, and $0-$250 per visit. The ground ambulance copay is $335 and the occupational therapy visit copay is $20. Hearing exam copay is $35 and routine vision copay is $0-$35.
HumanaChoice – $0 monthly premium with $7,350 maximum out-of-pocket expenses. 195 statewide members and 990 countrywide members. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $20. Diagnostic tests and procedure copay is $0-$50 and lab services copay is $0-$40. Inpatient and outpatient hospital copays are $195 for days 1-6, and $0-$225 per visit. The ground ambulance copay is $310 and the occupational therapy visit copay is $15. Hearing exam copay is $20 and routine vision copay is $0-$20.
Peoples Health Medicare Advantage Patriot No Rx LA – $0 monthly premium with $6,700 maximum out-of-pocket expenses. 818 statewide members and 834 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $0-$55. Diagnostic tests and procedure copay is $50 and lab services copay is $0. Inpatient and outpatient hospital copays are $350 for days 1-8, and $0-$350 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $50. Hearing exam copay is $0 and routine vision copay is $0.
Peoples Health Patriot – $0 monthly premium with $6,700 maximum out-of-pocket expenses. 1,997 statewide members and 2,147 countrywide members. Plan Summary Star Rating is 2.5, and pcp/specialist visit copays are $0 and $0-$55. Diagnostic tests and procedure copay is $50 and lab services copay is $0. Inpatient and outpatient hospital copays are $295 for days 1-6, and $0-$295 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $45. Hearing exam copay is $0 and routine vision copay is $0.
Wellcare Patriot Giveback – $0 monthly premium with $7,000 maximum out-of-pocket expenses. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $35. Diagnostic tests and procedure copay is $0-$40 and lab services copay is $0-$50. Inpatient and outpatient hospital copays are $325 for days 1-8, and $0-$500 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $35. Hearing exam copay is $35 and routine vision copay is $0-$35.
MA Plans With Prescription Drug Coverage
Aetna Medicare Signature Care HMO – $0 monthly premium with $6,750 maximum out-of-pocket expenses. 544 statewide members and 586 countrywide members. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $10-$55. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$20. Inpatient and outpatient hospital copays are $437 for days 1-7, and $0-$450 per visit. The ground ambulance copay is $300 and the occupational therapy visit copay is $30. Hearing exam copay is $55 and routine vision copay is $0-$55.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and 25% (Tier 5).
Aetna Medicare Signature Care PPO – $0 monthly premium with $7,900 maximum out-of-pocket expenses. 1,744 statewide members and 1,757 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $10-$45. Diagnostic tests and procedure copay is $0-$120 and lab services copay is $0-$15. Inpatient and outpatient hospital copays are $299 for days 1-7, and $0-$299 per visit. The ground ambulance copay is $295 and the occupational therapy visit copay is $35. Hearing exam copay is $45 and routine vision copay is $0-$45.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
Aetna Medicare Signature Giveback PPO – $0 monthly premium with $9,250 maximum out-of-pocket expenses. 1,346 statewide members and 1,362 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $0-$55. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$20. Inpatient and outpatient hospital copays are $388 for days 1-7, and $0-$450 per visit. The ground ambulance copay is $295 and the occupational therapy visit copay is $35. Hearing exam copay is $55 and routine vision copay is $0-$55.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
Aetna Medicare Signature Plus PPO – $0 monthly premium with $7,900 maximum out-of-pocket expenses. 3,354 statewide members and 3,664 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $0-$50. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$20. Inpatient and outpatient hospital copays are $272 for days 1-10, and $0-$272 per visit. The ground ambulance copay is $295 and the occupational therapy visit copay is $25. Hearing exam copay is $50 and routine vision copay is $0-$50.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 24% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
Aetna Medicare Value Care – $6 monthly premium with $6,750 maximum out-of-pocket expenses. 6,093 statewide members and 6,161 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $10-$35. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$10. Inpatient and outpatient hospital copays are $250 for days 1-10, and $0-$375 per visit. The ground ambulance copay is $295 and the occupational therapy visit copay is $35. Hearing exam copay is $35 and routine vision copay is $0-$35.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 22% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 22% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
Aetna Medicare Value Plus PPO – $32.90 monthly premium with $9,250 maximum out-of-pocket expenses. 594 statewide members and 661 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $0-$35. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$10. Inpatient and outpatient hospital copays are $388 for days 1-7, and $0-$450 per visit. The ground ambulance copay is $315 and the occupational therapy visit copay is $35. Hearing exam copay is $35 and routine vision copay is $0-$35.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 22% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 22% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
Blue adVantage Classic HMO – $0 monthly premium with $5,900 maximum out-of-pocket expenses. 23,462 statewide members and 23,471 countrywide members. Plan Summary Star Rating is 4.0, and pcp/ specialist visit copays are $0 and $40. Diagnostic tests and procedure copay is $0-$30 and lab services copay is $0. Inpatient and outpatient hospital copays are $195 for days 1-10, and $0-$250 per visit. The ground ambulance copay is $250 and the occupational therapy visit copay is $35. Hearing exam copay is $0 and routine vision copay is $40.
30-Day prescription drug copays – $0 (tier 1), $12 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $36 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
Blue adVantage Giveback HMO – $0 monthly premium with $6,500 maximum out-of-pocket expenses. 1,943 statewide members and 2,091 countrywide members. Plan Summary Star Rating is 4.0, and pcp/ specialist visit copays are $0 and $50. Diagnostic tests and procedure copay is $0-$30 and lab services copay is $0. Inpatient and outpatient hospital copays are $295 for days 1-7, and $0-$300 per visit. The ground ambulance copay is $250 and the occupational therapy visit copay is $35. Hearing exam copay is $0 and routine vision copay is $50.
30-Day prescription drug copays – $0 (tier 1), $12 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $36 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
Blue adVantage Liberty PPO – $0 monthly premium with $6,900 maximum out-of-pocket expenses. 1,221 statewide members and 1,440 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $50. Diagnostic tests and procedure copay is $0-$30 and lab services copay is $0. Inpatient and outpatient hospital copays are $320 for days 1-7, and $0-$300 per visit. The ground ambulance copay is $300 and the occupational therapy visit copay is $35. Hearing exam copay is $0 and routine vision copay is $50.
30-Day prescription drug copays – $0 (tier 1), $12 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $36 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
Blue adVantage Premier PPO – $160 monthly premium with $4,000 maximum out-of-pocket expenses. 1,074 statewide members and 1,267 countrywide members. Plan Summary Star Rating is 4.5, and pcp/ specialist visit copays are $0 and $40. Diagnostic tests and procedure copay is $0-$30 and lab services copay is $0. Inpatient and outpatient hospital copays are $170 for days 1-10, and $0-$200 per visit. The ground ambulance copay is $260 and the occupational therapy visit copay is $35. Hearing exam copay is $0 and routine vision copay is $40.
30-Day prescription drug copays – $0 (tier 1), $12 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $36 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
Blue adVantage Reliance HMO – $32.90 monthly premium with $4,100 maximum out-of-pocket expenses. 3,511 statewide members and 3,643 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $30. Diagnostic tests and procedure copay is $0-$30 and lab services copay is $0. Inpatient and outpatient hospital copays are $205 for days 1-10, and $0-$250 per visit. The ground ambulance copay is $250 and the occupational therapy visit copay is $35. Hearing exam copay is $0 and routine vision copay is $30.
30-Day prescription drug copays – $0 (tier 1), $12 (Tier 2), $45 (Tier 3), 50% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $36 (Tier 2), $135 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
DEVOTED CHOICE 005 PPO – $0 monthly premium with $3,900 maximum out-of-pocket expenses. Statewide members and countrywide member information not available. New plan so no Summary Star Rating. Pcp/specialist visit copays are $0 and $30. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$20. Inpatient and outpatient hospital copays are $175 for days 1-7, and $0-$275 per visit. The ground ambulance copay is $0-$315 and the occupational therapy visit copay is $30-$50. Hearing exam copay is $30 and routine vision copay is $0-$30.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 19% (Tier 3), 25% (Tier 4), and 28% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 19% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
DEVOTED CHOICE GIVEBACK 006 PPO – $0 monthly premium with $9,250 maximum out-of-pocket expenses. Statewide members and countrywide member information not available. New plan so no Summary Star Rating. Pcp/specialist visit copays are $0 and $50-$55. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$20. Inpatient and outpatient hospital copays are $450 for days 1-4, and $0-$450 per visit. The ground ambulance copay is $0-$300 and the occupational therapy visit copay is $35. Hearing exam copay is $55 and routine vision copay is $0-$20.
30-Day prescription drug copays – $0 (tier 1), $3 (Tier 2), 21% (Tier 3), 25% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $7.50 (Tier 2), 21% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
DEVOTED CHOICE GIVEBACK 001 PPO – $0 monthly premium with $3,900 maximum out-of-pocket expenses. Statewide members and countrywide member information not available. New plan so no Summary Star Rating. Pcp/specialist visit copays are $0 and $35. Diagnostic tests and procedure copay is $0-$95 and lab services copay is $0-$20. Inpatient and outpatient hospital copays are $195 for days 1-9, and $0-$295 per visit. The ground ambulance copay is $0-$315 and the occupational therapy visit copay is $35-$50. Hearing exam copay is $35 and routine vision copay is $0-$35.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 19% (Tier 3), 25% (Tier 4), and 28% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 19% (Tier 3), 25% (Tier 4), and n/a (Tier 5).
Humana Full Access PPO – $189 monthly premium with $3,300 maximum out-of-pocket expenses. 3,242 statewide members and 7,432 countrywide members. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $35. Diagnostic tests and procedure copay is $0-$100 and lab services copay is $0-$40. Inpatient and outpatient hospital copays are $0, and $0-$35 per visit. The ground ambulance copay is $335 and the occupational therapy visit copay is $35. Hearing exam copay is $0 and routine vision copay is $0-$35.
30-Day prescription drug copays – $0 (tier 1), $5 (Tier 2), $47 (Tier 3), 48% (Tier 4), and 31% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), $131 (Tier 3), 48% (Tier 4), and n/a (Tier 5).
Humana Gold Plus HMO – $0 monthly premium with $3,700 maximum out-of-pocket expenses. 27,861 statewide members and 27,929 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $30. Diagnostic tests and procedure copay is $0-$65 and lab services copay is $0. Inpatient and outpatient hospital copays are $85 for days 1-10, and $0-$155 per visit. The ground ambulance copay is $335 and the occupational therapy visit copay is $25. Hearing exam copay is $30 and routine vision copay is $0-$30.
30-Day prescription drug copays – $0 (tier 1), $5 (Tier 2), $47 (Tier 3), 43% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), $131 (Tier 3), 43% (Tier 4), and n/a (Tier 5).
Humana LCMC Advantage HMO – $0 monthly premium with $2,900 maximum out-of-pocket expenses. 4,552 statewide members and 4,583 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $20. Diagnostic tests and procedure copay is $0-$65 and lab services copay is $0. Inpatient and outpatient hospital copays are $0, and $0-$35 per visit. The ground ambulance copay is $335 and the occupational therapy visit copay is $20. Hearing exam copay is $20 and routine vision copay is $0-$20.
30-Day prescription drug copays – $0 (tier 1), $5 (Tier 2), $47 (Tier 3), 50% (Tier 4), and 33% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), $131 (Tier 3), 50% (Tier 4), and n/a (Tier 5).
Humana Select Partner Plan HMO – $0 monthly premium with $2,900 maximum out-of-pocket expenses. 5,329 statewide members and 5,348 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $20. Diagnostic tests and procedure copay is $0-$65 and lab services copay is $0. Inpatient and outpatient hospital copays are $65 for first 10 days, and $0-$100 per visit. The ground ambulance copay is $335 and the occupational therapy visit copay is $20. Hearing exam copay is $20 and routine vision copay is $0-$20.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), $30 (Tier 3), 47% (Tier 4), and 33% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), $60 (Tier 3), 47% (Tier 4), and n/a (Tier 5).
Peoples Health Choices PPO – $0 monthly premium with $6,700 maximum out-of-pocket expenses. 4,933 statewide members and 4,981 countrywide members. Plan Summary Star Rating is 2.5, and pcp/specialist visit copays are $0 and $0-$55. Diagnostic tests and procedure copay is $5 and lab services copay is $0. Inpatient and outpatient hospital copays are $295 for first 7 days, and $0-$295 per visit. The ground ambulance copay is $120 and the occupational therapy visit copay is $20. Hearing exam copay is $0 and routine vision copay is $0.
30-Day prescription drug copays – $0 (tier 1), $10 (Tier 2), 16% (Tier 3), 41% (Tier 4), and 26% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 16% (Tier 3), n/a (Tier 4), and n/a (Tier 5).
Peoples Health Choices 65 HMO – $0 monthly premium with $3,900 maximum out-of-pocket expenses. 59,362 statewide members and 59,415 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $0-$30. Diagnostic tests and procedure copay is $50 and lab services copay is $0. Inpatient and outpatient hospital copays are $95 for first 10 days, and $0-$125 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $30. Hearing exam copay is $20 and routine vision copay is $0.
30-Day prescription drug copays – $0 (tier 1), $5 (Tier 2), 21% (Tier 3), 43% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 21% (Tier 3), n/a (Tier 4), and n/a (Tier 5).
Peoples Health Complete Care HMO – $0 monthly premium with $3,900 maximum out-of-pocket expenses. 11,817 statewide members and 11,850 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $0-$20. Diagnostic tests and procedure copay is $50 and lab services copay is $0. Inpatient and outpatient hospital copays are $95 for first 10 days, and $0-$125 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $20. Hearing exam copay is $0 and routine vision copay is $0.
30-Day prescription drug copays – $0 (tier 1), $5 (Tier 2), 23% (Tier 3), 46% (Tier 4), and 29% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 23% (Tier 3), n/a (Tier 4), and n/a (Tier 5).
Peoples Health Medicare Advantage Giveback HMO – $0 monthly premium with $6,700 maximum out-of-pocket expenses. 3,189 statewide members and 3,206 countrywide members. Plan Summary Star Rating is 4.0, and pcp/specialist visit copays are $0 and $0-$50. Diagnostic tests and procedure copay is $45 and lab services copay is $0. Inpatient and outpatient hospital copays are $435 for first 7 days, and $0-$435 per visit. The ground ambulance copay is $270 and the occupational therapy visit copay is $50. Hearing exam copay is $20 and routine vision copay is $0.
30-Day prescription drug copays – $0 (tier 1), $10 (Tier 2), 15% (Tier 3), 39% (Tier 4), and 28% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 15% (Tier 3), n/a (Tier 4), and n/a (Tier 5).
Wellcare Assist HMO – $31.90 monthly premium with $4,200 maximum out-of-pocket expenses. 1,082 statewide members and 1,225 countrywide members. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $25. Diagnostic tests and procedure copay is $0-$20 and lab services copay is $0-$50. Inpatient and outpatient hospital copays are $300 for first 9 days, and $0-$300 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $25. Hearing exam copay is $25 and routine vision copay is $0-$25.
30-Day prescription drug copays – $18 (tier 1), $19 (Tier 2), 25% (Tier 3), $100 (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 25% (Tier 3), $200 (Tier 4), and n/a (Tier 5).
Wellcare Simple HMO – $0 monthly premium with $3,400 maximum out-of-pocket expenses. 622 statewide members and 625 countrywide members. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $20. Diagnostic tests and procedure copay is $0-$30 and lab services copay is $0-$50. Inpatient and outpatient hospital copays are $275 for first 7 days, and $0-$280 per visit. The ground ambulance copay is $275 and the occupational therapy visit copay is $35. Hearing exam copay is $20 and routine vision copay is $0-$20.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 25% (Tier 3), 36% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 25% (Tier 3), 36% (Tier 4), and n/a (Tier 5).
Wellcare Giveback HMO – $0 monthly premium with $9,250 maximum out-of-pocket expenses. Membership numbers are not available. Plan Summary Star Rating is 3.5, and pcp/specialist visit copays are $0 and $40. Diagnostic tests and procedure copay is $0-$50 and lab services copay is $0-$50. Inpatient and outpatient hospital copays are $495 for first 4 days, and $0-$500 per visit. The ground ambulance copay is $300 and the occupational therapy visit copay is $35. Hearing exam copay is $40 and routine vision copay is $0-$40.
30-Day prescription drug copays – $0 (tier 1), $0 (Tier 2), 25% (Tier 3), 49% (Tier 4), and 25% (Tier 5). 90-Day mail-order prescription drug copays – $0 (tier 1), $0 (Tier 2), 25% (Tier 3), 49% (Tier 4), and n/a (Tier 5).
Short Term Health Insurance
The maximum duration of coverage is four months, although longer durations may be approved within the next 12-18 months. Plans are non-renewable and typically, pre-existing conditions are not covered. Premium Tax Credits (PTC) are also not offered on temporary contracts. Thus, these types of plans are generally not suitable if you qualify for ACA Marketplace or employer-provided group coverage.
Monthly rates shown below are for Baton Rouge area residents. Rates can slightly vary, depending upon your county of residence. Plans are medically-underwritten.
30-Year-Old Male
$78.07 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$91.28 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$117.77 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$130.17 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
$135.53 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$230.51 – UnitedHealthcare Medical Copay $7,500 deductible with $50 copay on office visits.
35-Year-Old Female
$92.04 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$107.97 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$139.90 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$154.89 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
$183.54 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$295.24 – UnitedHealthcare Medical Copay $7,500 deductible with $50 copay on office visits.
40-Year-Old Married Couple
$215.99 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$254.25 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$300.32 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$368.67 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
$344.01 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$585.13 – UnitedHealthcare Medical Copay $7,500 deductible with $50 copay on office visits.
40-Year-Old Married Couple With One Child
$257.36 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$303.91 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$359.72 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$425.27 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$442.48 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
$723.34 – UnitedHealthcare Medical Copay $7,500 deductible with $50 copay on office visits.
45-Year-Old Married Couple With One Child
$355.14 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$417.16 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$492.40 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$492.62 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$604.60 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
$837.52 – UnitedHealthcare Medical Copay $7,500 deductible with $50 copay on office visits.
50-Year-Old Female
$211.95 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$246.98 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$290.17 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$287.97 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$354.42 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
$489.80 – UnitedHealthcare Medical Copay $7,500 deductible with $50 copay on office visits.
55-Year-Old Male
$274.01 – UnitedHealthcare Medical Value $15,000 deductible with deductible on office visits.
$326.47 – Everest Flex $10,000 50/50% $10,000 deductible with $50 copay on office visits.
$362.07 – UnitedHealthcare Medical Value $7,500 deductible with deductible on office visits.
$376.68 – Everest Flex $5,000 50/50% $5,000 deductible with $50 copay on office visits.
$440.80 – Everest Flex $2,500 50/50% $2,500 deductible with $50 copay on office visits.
$536.23 – Everest Flex $1,000 50/50% $1,000 deductible with $50 copay on office visits.
Louisiana Part D Prescription Drug Plans
Ten plans are available (down from 14 last year) including five enhanced and five basic policy options. One $0 deductible plans is offered (Humana Premier Rx Plan), with a monthly rate of $113.70. Four plans feature monthly premiums less than $25, and the average weighted PDP monthly premium is $37.77. Seven plans had rate decreases while three plans had rate increases.
AARP Medicare Rx Preferred from UHC – $139.50 monthly premium with $130 deductible. 3,537 formulary drugs available. 30-day drug copays are $5 preferred generic drug copay, $10 generic drug copay, 15% preferred brand drug copay, 36% non-preferred drug copay and 31% specialty drug copay. 90-day drug copays are $15 preferred generic drug copay, $30 generic drug copay, 15% preferred brand drug copay, n/a non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 267, Tier 2 – 629, Tier 3 – 1,037, Tier 4 – 931, and Tier 5 – 678. 16,187 members enrolled in the state and 1,814,730 members enrolled nationally. The Plan Summary Star Rating is 2.0.
AARP Medicare Rx Saver from UHC – $37.70 monthly premium with $615 deductible. 3,074 formulary drugs available. 30-day drug copays are $2 preferred generic drug copay, $6 generic drug copay, 16% preferred brand drug copay, 40% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $6 preferred generic drug copay, $18 generic drug copay, 16% preferred brand drug copay, n/a non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 54, Tier 2 – 442, Tier 3 – 963, Tier 4 – 962, and Tier 5 – 659. 6,501 members enrolled in the state and 582,021 members enrolled nationally. The Plan Summary Star Rating is 2.0.
HealthSpring Assurance – $48.40 monthly premium with $615 deductible. 3,214 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $2 generic drug copay, 20% preferred brand drug copay, 30% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $6 generic drug copay, 20% preferred brand drug copay, 30% non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 216, Tier 2 – 485, Tier 3 – 623, Tier 4 – 1,162, and Tier 5 – 734. 3,787 members enrolled in the state and 1,160,620 members enrolled nationally. The Plan Summary Star Rating is 2.5.
HealthSpring Extra Rx – $60.60 monthly premium with $615 deductible. 3,306 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $5 generic drug copay, 17% preferred brand drug copay, 30% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $15 generic drug copay, 17% preferred brand drug copay, 30% non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 313, Tier 2 – 378, Tier 3 – 968, Tier 4 – 931, and Tier 5 – 721. 7,874 members enrolled in the state and 375,259 members enrolled nationally. The Plan Summary Star Rating is 2.5.
Humana Basic Rx Plan – $0 monthly premium with $615 deductible. 2,971 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $1 generic drug copay, 25% preferred brand drug copay, 32% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $3 generic drug copay, 25% preferred brand drug copay, n/a non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 176, Tier 2 – 527, Tier 3 – 774, Tier 4 – 894, and Tier 5 – 608. 32,226 members enrolled in the state and 122,110 members enrolled nationally. The Plan Summary Star Rating is 3.0.
Humana Premier Rx Plan – $113.70 monthly premium with $0 deductible. 3,071 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $4 generic drug copay, $45 preferred brand drug copay, 50% non-preferred drug copay and 33% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $12 generic drug copay, $135 preferred brand drug copay, 50% non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 386, Tier 2 – 559, Tier 3 – 619, Tier 4 – 906, and Tier 5 – 608. 9,884 members enrolled in the state and 586,100 members enrolled nationally. The Plan Summary Star Rating is 3.0.
Humana Value Rx Plan – $19.30 monthly premium with $601 deductible. 3,009 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $0 generic drug copay, 20% preferred brand drug copay, 35% non-preferred drug copay and 26% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $0 generic drug copay, 20% preferred brand drug copay, n/a non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 314, Tier 2 – 605, Tier 3 – 582, Tier 4 – 907, and Tier 5 – 608. 21,940 members enrolled in the state and 1,593,904 members enrolled nationally. The Plan Summary Star Rating is 3.0.
SilverScript Choice – $44.70 monthly premium with $615 deductible. 3,655 formulary drugs available. 30-day drug copays are $2 preferred generic drug copay, $10 generic drug copay, 19% preferred brand drug copay, 35% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $6 preferred generic drug copay, $30 generic drug copay, 19% preferred brand drug copay, 35% non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 463, Tier 2 – 908, Tier 3 – 418, Tier 4 – 1,090, and Tier 5 – 785. 28,450 members enrolled in the state and 1,898,894 members enrolled nationally. The Plan Summary Star Rating is 3.0.
WellCare Classic – $6.70 monthly premium with $615 deductible. 2,919 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $10 generic drug copay, 25% preferred brand drug copay, 28% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $30 generic drug copay, 25% preferred brand drug copay, 28% non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 124, Tier 2 – 396, Tier 3 – 641, Tier 4 – 1,117, and Tier 5 – 650. 26,169 members enrolled in the state and 2,692,523 members enrolled nationally. The Plan Summary Star Rating is 3.5.
WellCare Value Script – $5.70 monthly premium with $615 deductible. 3,187 formulary drugs available. 30-day drug copays are $0 preferred generic drug copay, $3 generic drug copay, 25% preferred brand drug copay, 40% non-preferred drug copay and 25% specialty drug copay. 90-day drug copays are $0 preferred generic drug copay, $9 generic drug copay, 25% preferred brand drug copay, 40% non-preferred drug copay, and n/a specialty drug copay. The number of available drugs: Tier 1 – 362, Tier 2 – 539, Tier 3 – 341, Tier 4 – 1,288, and Tier 5 – 6490. 54,410 members enrolled in the state and 6,064,951 members enrolled nationally. The Plan Summary Star Rating is 3.5.