Before you start

Louisiana residence
Income information for subsidy or Medicaid eligibility
An SSN or ITIN for marketplace applications
Evidence of your move, if enrolling outside the annual window

Step-by-step

1
Enrol in your employer's plan within the new-hire window
Typically 30 days from your start date. Compare the deductible and out-of-pocket maximum rather than the premium alone. In this metro the strongest plans generally come from the state, the hospital systems, LSU and the major petrochemical employers; contractor roles in the corridor vary a great deal.
Via employerWho: YouFirst 30 days of employment
2
Check Louisiana Medicaid first if your income is modest
Louisiana expanded Medicaid with effect from July 2016, so low-income adults are covered rather than falling into a gap. Enrolment runs year-round with no annual window, which is not true of the marketplace.
OnlineWho: You
3
Without an employer plan, apply through HealthCare.gov
Louisiana has no state exchange, so the federal marketplace is where you apply and where the advance premium tax credit is calculated. Open Enrollment runs on the federal calendar, from 1 November, and the dates are published on the site each year.
OnlineWho: You
4
Use the move as a Special Enrollment Period rather than waiting
A permanent move to a new area is a qualifying life event, generally opening a 60-day window. Someone arriving in April can enrol in April.
OnlineWho: YouWithin 60 days of moving
5
Register with a primary care practice early
New-patient waits across the Capital Region are long and the parishes around it are worse, which pushes demand into the city. Federally qualified health centres charge on a sliding fee scale regardless of insurance status and are the fallback worth knowing about before you need it.
In personWho: You
6
Look at the air monitoring data for the area you are moving to
LDEQ operates and publishes ambient air monitoring across the industrial corridor. If anyone in the household has asthma or another respiratory condition, that data is worth reading before choosing between the north side and the south-east — and it is a better basis for the decision than either the industry's or the campaigners' summary of it.
OnlineWho: YouBefore signing a lease

Documents you’ll need

Proof of Louisiana residence
Income documentation for subsidies or Medicaid
SSN or ITIN
Immigration documents for marketplace eligibility categories
Evidence of your move or of losing prior coverage, for a Special Enrollment Period

Things most newcomers don’t know

Louisiana expanded Medicaid, and its neighbours mostly did not.

Expansion took effect in July 2016, so an adult below the threshold is covered here rather than falling into the gap that exists in Texas, Mississippi and South Carolina. Enrolment is year-round with no window. If your first year here will be lean, or a spouse is not yet working, check Medicaid before assuming a marketplace plan is the only option.

Source: Louisiana Department of Health — Medicaid

Air quality here is a health variable with public data behind it.

The industrial corridor between Baton Rouge and New Orleans is one of the densest concentrations of petrochemical capacity in the country, and LDEQ monitors and publishes ambient air data across it. That is unusual and useful: rather than choosing a neighbourhood on impression, you can read what the monitors actually record. It matters most for asthma, COPD and anyone with a cardiac condition.

Source: Louisiana Department of Environmental Quality

Moving here is itself a qualifying life event.

You do not have to wait until November. A permanent move to a new area opens a Special Enrollment Period, generally 60 days long. People sit uninsured for months because they assume the annual window is the only door.

Source: HealthCare.gov — dates and deadlines

Plan for a multi-day power outage, not a stormy afternoon.

Hurricanes reach Baton Rouge as wind and rain rather than surge, and the practical consequence is grid outages lasting days across a metro where August heat is dangerous without air conditioning. Refrigerated medication, powered medical equipment and a fortnight's supply of prescriptions are the preparations that matter, and they have to be made before the season rather than during a storm.

Source: Ready.gov — hurricanes and evacuation planning

Common mistakes to avoid

Assuming Louisiana did not expand Medicaid because most of its neighbours did not.
Waiting for November when moving here already opened a Special Enrollment Period.
Choosing a neighbourhood near the corridor without looking at the monitoring data first.
Not registering for a primary care practice until you are ill.
Entering hurricane season without a plan for a multi-day outage in August heat.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.

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