Louisiana Health Insurance Consumer Guide

If these apply to you, you can buy individual and family health insurance from Louisiana’s Marketplace:

• You live in Louisiana.
• You are lawfully present in the U.S.
• You’re not enrolled in Medicare.
• You’re not incarcerated.

Many people, like early retirees not yet on Medicare, self-employed people, and those who work for small businesses without health benefits, buy health insurance on the Marketplace.

Eligibility for financial assistance, such as premium subsidies and cost-sharing reductions, is based on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. This cost depends on your age and location. In addition, you may qualify for financial assistance in the Marketplace if:

• You don’t have access to affordable health coverage through your employer. If your employer offers coverage, but you feel it’s too expensive, our Employer Health Plan Affordability Calculator can help you understand if you might qualify for premium subsidies. 
• You’re not eligible for Medicaid or CHIP.

You can sign up for ACA-compliant individual and family health plans in Louisiana between November 1 and January 15. This is known as open enrollment.⁵

• Coverage starts on January 1 if you enroll by December 15.
• Coverage starts February 1 if you enroll between December 16 and January 15.

After January 15, you can sign up for or make changes to an ACA Marketplace health through a special enrollment period (SEP). To qualify for a SEP, you’ll need a qualifying life event.

But there are instances where you don’t need a qualifying life event to apply outside of open enrollment. For example:

• If you’re eligible for premium tax credits and your income is not more than 150% of the poverty level, you can enroll anytime until at least 2025.⁶
• If you’re a Native American, you can enroll whenever necessary.⁷
• If you lose Medicaid or CHIP between March 31, 2023 and July 31, 2024, you can enroll through the extended SEP.⁸ 

• Directly through HealthCare.gov, the ACA exchange website
• By phone at (800) 318-2596 (TTY: 1-855-889-4325). Talk to an agent 24 hours a day, seven days a week, except for holidays.

With the help of agents, navigators, or certified application counselors or an approved enhanced direct enrollment entity.⁹

In Louisiana, people who can’t get health plans through an employer may find affordable coverage on the ACA Marketplace (HealthCare.gov). Under ACA, you may qualify for income-based subsidies called Advance Premium Tax Credits (APTC). These credits lower your premiums.

During the 2023 open enrollment period:

• 94% of Marketplace enrollees in Louisiana qualified for premium subsidies, saving on average about $680 monthly in premiums.¹⁰ 
• With subsidies, enrollees paid an average of just $94 per month for health coverage.¹⁰

Source: CMS.gov¹¹

In addition to APTC, you may qualify for cost-sharing reductions (CSR), which help you pay for your deductibles and out-of-pocket expenses. Your income must be less than 250% of the federal poverty level to be eligible for CSR.¹² 

Another way to find affordable health insurance in Louisiana is through the state’s Medicaid program. 

Short-term plans may be a low-cost alternative for those who are not eligible for employer coverage, Medicare, Medicaid, or subsidies. However, they generally offer less benefits and consumer protections.

In 2023, six insurance companies provide plans through Louisiana’s exchange, including two recent additions: Ambetter from Louisiana Healthcare Connections and UnitedHealthcare.¹³

• Ambetter from Louisiana Healthcare Connections
• Blue Cross Blue Shield of Louisiana
• Christus
• HMO Louisiana
• UnitedHealthcare
• Vantage Health Plan

Louisiana’s individual market insurers have proposed the following rate increases for 2024:¹³

It’s important to note that rate increases apply to the full-price premiums. However, because most people using Louisiana’s exchange receive premium tax credits, they don’t have to pay the entire cost.¹⁴ If you qualify for these subsidies, your actual rate change depends on your plan’s cost and the subsidy amount you receive.

In 2021, the American Rescue Plan expanded the availability of premium subsidies. These changes have now been extended until 2025 by the Inflation Reduction Act.¹⁵

In the 2023 open enrollment period, 120,804 people signed up for private qualified health plans (QHPs) using Louisiana’s exchange.¹⁰

 The 2023 enrollment was the largest since 2016. 

Source: 2014,¹⁶ 2015, ¹⁷ 2016,¹⁸ 2017,¹⁹ 2018,²⁰ 2019,²¹ 2020,²² 2021,²³ 2022,²⁴ 2023,²⁵ 2024²⁶

HealthCare.gov
The official website where residents of Louisiana can shop for and buy health insurance plans that meet their needs. 

Department of Health & Hospitals
This is a governmental body responsible for health services and programs in Louisiana.

Louisiana Department of Insurance
The Louisiana Department of Insurance provides various resources related to health insurance, helping people understand their options and make informed choices.

Medicare Rights Center
A national organization that offers assistance and information about Medicare through its website and call center.

Louisiana Senior Health Insurance Information Program (SHIP)
Assists people on Medicare, providing information and guidance about their health insurance options.

Louisiana Department of Health – Medicaid
Oversees the state’s Medicaid program, which provides health coverage for eligible low-income individuals and families.