Before you start

Louisiana residence
Income information for subsidy or Medicaid eligibility
An SSN or ITIN for the marketplace application
A qualifying life event, if enrolling outside the annual open-enrolment window

Step-by-step

1
Enrol in your employer's plan within the new-hire window
Typically 30 days from your start date, and missing it can mean waiting for the next open enrolment. Compare the deductible and out-of-pocket maximum, not just the premium.
Via employerWho: YouFirst 30 days of employment
2
Check Louisiana Medicaid eligibility first
Louisiana expanded Medicaid in 2016, covering adults up to 138% of the federal poverty level, and enrolment runs year-round rather than in a window. Newcomers on modest early incomes frequently qualify. Apply through the Louisiana Department of Health.
OnlineWho: You
3
Without an employer plan, use HealthCare.gov
Louisiana has no state exchange, so the federal marketplace is where individual plans are bought. Open enrolment runs on a fixed annual calendar; outside it you need a qualifying life event such as moving state, losing coverage, marriage or a birth. There is no state-run alternative to fall back on.
OnlineWho: You
4
Choose the plan by hospital system, because here that is the real choice
Ochsner and LCMC between them account for most adult care in the metro, and networks are drawn along the two. Decide which system your nearest clinic, your likely specialists and — if you have children — Children's Hospital New Orleans belong to, then buy the plan that covers it. Switching mid-year needs a qualifying life event.
OnlineWho: You
5
Register with a primary care physician in month one
Do it while you are well. An established relationship is what gets you referrals and urgent slots later, and confirming the practice is in your network before the first visit avoids an out-of-network bill for a routine appointment.
In personWho: YouMonth 1
6
Set up your prescriptions with hurricane season in mind
Louisiana law provides for emergency prescription refills during a declared state of emergency, and pharmacies here are used to it — but the process is smoother if your pharmacy already has your records and you are not on the last three days of a supply when the cone appears. Keep a fortnight in hand from June, and keep a written list of medications and doses with your evacuation documents.
In personWho: YouBefore 1 June
7
Take heat and mosquitoes seriously, in that order
Summer here combines high thirties Celsius with humidity that makes evaporative cooling ineffective, and heat illness sends people to emergency departments every August. Louisiana also runs an active mosquito-borne disease surveillance programme — West Nile is endemic. Both are managed with unglamorous habits: hydrate, work outdoors early, and use repellent at dusk.
In personWho: You
8
Learn the urgent care versus emergency room distinction
An emergency room visit for something a clinic could treat can cost thousands even when insured. Urgent care handles fractures, stitches and infections far more cheaply, and both systems run urgent-care sites across the metro.
In personWho: You

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 losing prior coverage, if using a special enrolment period
A written medication list, kept with your evacuation documents

Things most newcomers don’t know

The plan choice here is really a choice between two hospital systems.

Ochsner and LCMC dominate the metro and marketplace networks are built around them. A plan that is cheaper by twenty dollars a month but excludes the system your GP, your specialist and your children's hospital sit in is not cheaper. Work out the system first and the premium second — this is a sharper trade-off in New Orleans than in most US cities.

Source: community-reported

Louisiana expanded Medicaid, which is the difference from Texas.

Since July 2016 an adult earning below the subsidy floor is covered here rather than falling into the hole that persists in non-expansion states. For a newcomer whose first months are lean — a spouse not yet working, a contract not yet started — that is a genuine safety net, and it enrols year-round rather than in a window.

Source: Louisiana Department of Health — Medicaid

Louisiana has no state exchange, so the federal deadline is the only deadline.

States like Maryland and California run their own marketplaces with longer windows and extra subsidies. Louisiana does not. If you miss HealthCare.gov's open enrolment and have no qualifying life event, there is no state alternative and you are uninsured until the next window. Diary the date on arrival.

Source: HealthCare.gov

Your prescriptions are part of your hurricane plan.

Louisiana provides for emergency refills during a declared emergency, but an evacuation is a bad moment to discover your pharmacy has no record of you or that a controlled medication needs a fresh prescription. Establish the pharmacy relationship in the spring and carry a written list of medications and doses in the document pack you evacuate with.

Source: Louisiana Department of Health

Common mistakes to avoid

Missing HealthCare.gov open enrolment and finding Louisiana has no state fallback.
Buying the cheaper plan and discovering it excludes the hospital system your doctors are in.
Missing the 30-day new-hire enrolment window at a new employer.
Missing a Louisiana Medicaid renewal and losing coverage you still qualified for.
Entering hurricane season with three days of a prescription and no pharmacy record.

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

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