An important note to our patients on CrescentCare, Open Enrollment, and your insurance plan
To patients picking a plan during Open Enrollment: not all plans include CrescentCare as “in-network” and this can affect the cost of your care. If you want CrescentCare visits billed to your insurance, confirm we are in your plan’s network before you enroll.
Some Medicare Advantage plans are built around a single health system (Ochsner or LCMC). As an independent health center, CrescentCare is not affiliated with either system and cannot participate in those plans. Read the FAQ below to learn more about how to review your current plan, what to look for in a new plan, and how to get help choosing the plan you need.
Frequently Asked Questions
What is Open Enrollment
The annual Medicare Open Enrollment period is your opportunity to review your health coverage and make changes for the coming year. Open Enrollment runs from October 15 through December 7, and any changes made during this period generally become effective on January 1.
If you receive care at our health center, we encourage you to review your options carefully and verify that your providers remain in network before selecting a new plan.
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When is Open Enrollment
October 15 – December 7 : Medicare Open Enrollment
During this period, you may:
- Switch Medicare Advantage plans
- Switch from Original Medicare to Medicare Advantage
- Return from Medicare Advantage to Original Medicare
- Join, switch, or drop a Medicare Part D prescription drug plan
Changes take effect January 1.
January 1 – March 31: Medicare Advantage Open Enrollment Period
If you are already enrolled in a Medicare Advantage plan, you may:
- Switch to another Medicare Advantage plan
- Return to Original Medicare
Coverage changes generally become effective the first day of the month after your enrollment request is received.
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Do I have to change my Medicare plan?
No. If you are satisfied with your current coverage, you do not have to make any changes. However, plans may change premiums, copays, provider networks, prescription coverage, and benefits from year to year. Reviewing your plan annually can help ensure it still meets your healthcare needs.
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Why should I review my plan every year?
Healthcare needs and coverage options can change. A different plan may offer:
- Lower out-of-pocket costs
- Better prescription drug coverage
- Additional benefits
- Improved access to your preferred providers
- Medicare recommends reviewing your options during Open Enrollment every year.
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I receive care at a Federally Qualified Health Center (FQHC). What should I know before changing plans?
Before enrolling in a new Medicare Advantage plan, verify that:
- Our health center participates in the plan’s network
- Your primary care provider is in network
- Your specialists are in network
- Your preferred pharmacy participates
- Your prescriptions are covered
Changing plans without verifying network participation could affect your access to care and may increase your out-of-pocket costs.
How do I know if my doctor is in network?
Contact the health plan directly or call our office at 504-821-2601 before enrolling in a new plan. We can help you verify whether we participate with the plan you are considering.
What if I miss the December 7 deadline?
In most cases, you must wait for another enrollment opportunity unless you qualify for a Special Enrollment Period due to certain life events or special circumstances.
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Where can I compare Medicare plans?
Visit the official Medicare website at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) for assistance comparing plans and coverage options.
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What should I do before I enroll in a new plan?
Medicare Enrollment Checklist
- Review your current plan benefits and costs
- Compare available Medicare plans
- Verify prescription drug coverage
- Confirm your pharmacy is participating
- Verify that your providers are in network
- Contact our office with any questions before switching plans
When will changes made during Open Enrollment affect my care?
Medicare Open Enrollment runs from October 15 through December 7, and any changes made during this period generally become effective on January 1.
Medicare Advantage Open Enrollment Period runs from January 1 though March 31st, Coverage changes generally become effective the first day of the month after your enrollment request is received.
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Who can help me with this? I need assistance.
If you are considering changing your Medicare coverage, contact our office before enrolling in a new plan. We are happy to help verify whether our health center participates in the plan and answer questions about how a change in coverage may affect your care.
Important: Always confirm that your healthcare providers and specialists are in network before choosing a new Medicare plan. Doing so can help avoid unexpected costs and interruptions in care.
Glossary Terms
Annual Notice of Change
A letter your Medicare plan must send each fall, by the end of September, explaining what is changing next year: costs, coverage, drug list, and sometimes the provider network. Read it before open enrollment.
Coinsurance
Your percentage of the cost of a covered service after you meet your deductible. With 20% coinsurance on a $100 bill, you pay $20 and the plan pays $80.
Copay
A flat fee for a specific service, like $20 for a doctor visit or $10 for a prescription.
Deductible
What you pay out of pocket for covered care before your plan starts paying its share. Some services may be covered before you meet it, so check your plan.
Federally Qualified Health Center (FQHC)
A Federally Qualified Health Center (FQHC) is a nonprofit health organization or clinic that receives federal grant funding to serve medically underserved areas and populations. Services are provided on a sliding scale fee based on individuals’ abilities to pay. More information about FQHCs can be found at HRSA.gov.
Formulary
The plan’s list of covered prescription drugs, grouped in tiers that decide what you pay. A drug you take now may not be on next year’s list.
HMO / PPO
HMO: you generally must use the plan’s network and may need referrals; out-of-network care is usually not covered except in emergencies. PPO: more freedom to go outside the network, but you usually pay more when you do.
In-network
Doctors, clinics, and hospitals that have a contract with your plan. Visiting them costs you less, and your plan processes the bill as it should.
Narrow network
A plan that covers only a small, limited group of providers, often tied to one health system. If your doctor is not in that group, your visits may not be covered. CrescentCare is independent and cannot participate in plans limited to one system’s providers.
Out-of-network
Providers that do not have a contract with your plan. You may pay much more, pay the full cost, or not be covered at all (except in an emergency).
Premium
The amount you pay every month to keep your insurance, whether or not you see a doctor.
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