Louisiana Affordable Healthcare Insurance Coverage

If you are living and loving life in the Pelican State, then finding the right health insurance plan can only make things better. This is a critical choice for every healthcare consumer in the state, but if this is the year you are going to get help for a drug or alcohol addiction, then that decision is especially important. Substance abuse treatment is one of the essential services defined by the Affordable Care Act, but the amount of coverage varies by provider and policy. Consider carefully what insurance companies are offering in Louisiana before making your selection.

Blue Cross Blue Shield of Louisiana

The residents of this southern state have a number of choices for health insurance, but the provider offering the most policies is Blue Cross Blue Shield of Louisiana. This company has 14 different plans available in the state, including five Bronze, six Silver, and three Gold policies. All of their offerings are PPO plans, meaning you don’t have to go through a primary care physician for services including substance abuse treatment.

At the Bronze level, Blue Cross Blue Shield of Louisiana has plans with high deductibles, so they work best for someone with access to a health savings plan. The deductibles range from $3,600 to $6,450. The deductible is an important consideration because with this company, you must meet if fully before they pay towards that cost of your care, not just for drug treatment, but for all services.

There is also a difference in the deductible levels if you choose to go out-of-network. For example, the Blue Max 80/60 $5000 plan lists a $5,000 deductible but that covers in-network providers only; if you go out-of-network that number jumps to $10,000 for an individual.

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The higher the deductible, the lower your contribution is towards both in and outpatient care. The highest deductible plan is the Blue Saver 100/100 $6450. Once you meet the deductible, BCBS pays the full amount for all types of substance abuse treatment. The lowest deductible plan, Blue Saver 60/40 $3600, requires you to make a 40 percent coinsurance payment for both in and outpatient treatment and 60 percent if you go out-of-network.

The higher metal level plans follow that same trend, but with lower deductibles. At the Silver level, they range from $1,900 to $4,000. The highest deductible plan pays all your treatment costs and the lowest, Blue Saver 80/60 $1900, requires a 20 percent coinsurance payment in-network and 40 percent out-of-network. All the Gold plans pay the full cost of treatment after you meet the deductible as long as you stay in-network.

HMO Louisiana

If you prefer the HMO plan format, then the next largest contributor to the health insurance market is HMO Louisiana. Their plans all fall under one of two brand names: Community Blue and Blue POS. The four programs available at the Bronze level carry deductibles from $4,500 to $6,750, with a one lower deductible and one higher deductible plan under each brand name. As with BCBS, there is a separate deductible if you choose to go out-of-network for treatment. For example, the Community Blue 70/50 $4500 lists a $9,000 deductible for out-of-network services. If you stay in-network, you pay the lower deductible and the company covers 100 percent of your outpatient care and 80 percent for inpatient treatment. If you go out-of-network for drug rehab, they will only cover 50 percent of the total costs after the deductible. With the higher deductible Community Blue plan, you make a 20 percent coinsurance payment for in-network care and 40 percent out-of-network.

With the Bronze Blue POS plans, your contribution is 30 percent percent for the lower deductible policy for both in and outpatient treatment and 50 percent if you go out-of-network. On the higher deductible plan, it drops to 20/40.

The higher metal level plans vary by policy. For example, the Community Blue Copay 70/50 $3500 plan offers 30 percent coinsurance for inpatient care and full coverage for outpatient services including testing and procedures. With Blue POS 100/80 $3500, it changes to no charge after the deductible for all services including substance abuse treatment.

The goal for Louisiana residents is to find a policy with a deductible they can meet and then investigate what the plan pays for each service. The right health insurance support will make seeking treatment for a drug problem much more affordable this coming year.

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