A non-government entity
American Health Advantage of Louisiana (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for American Health Advantage of Louisiana (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on American Health Advantage of Louisiana (HMO I-SNP) in 2026, please refer to our full plan details page.
American Health Advantage of Louisiana (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Select Parishes in Louisiana. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that American Health Advantage of Louisiana (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
American Health Advantage of Louisiana (HMO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about American Health Advantage of Louisiana (HMO I-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For American Health Advantage of Louisiana (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.90. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The American Health Advantage of Louisiana (HMO I-SNP) prescription drug coverage includes an annual drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your medications before the plan starts covering its share of your prescription costs. Specific drug coverage tier details, such as copayments and coinsurance rates for different drug levels, are currently not available for this plan. For the most accurate and up-to-date pricing on your specific medications, it is best to consult the plan's formulary directly.
Additional Benefits
The American Health Advantage of Louisiana (HMO I-SNP) provides comprehensive medical coverage, featuring no copay and no coinsurance for primary care visits, home health services, and skilled nursing facility stays up to 100 days. Specialist visits, outpatient hospital services, and emergency care are covered with no copay and a standard 20% coinsurance, though prior authorization is required for many of these services. Inpatient hospital stays are partially covered with no coinsurance, although Medicare-defined copayments still apply. For supplemental care, this plan offers routine vision and hearing benefits with no copays and a 20% coinsurance, including an annual eyewear allowance of up to $370 and prescription hearing aid coverage. Durable medical equipment and Medicare-covered dental services are also accessible with no copay and a 20% coinsurance. Additionally, Medicare Part B insulin drugs are available with a $35 copay and no coinsurance, while other Part B drugs feature no copay and up to a 20% coinsurance.
Inpatient Hospital See details
American Health Advantage of Louisiana (HMO I-SNP) partially covers inpatient acute and psychiatric hospital stays with no coinsurance, though Medicare-defined copayments apply and prior authorization is required. Additional hospital days, non-Medicare-covered stays, and room upgrades are not covered under this plan.
Outpatient Services See details
American Health Advantage of Louisiana (HMO I-SNP) covers outpatient services with no copay and a 20% coinsurance, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for outpatient hospital, observation, and ambulatory surgical center services, and there is no deductible for blood services.
Partial Hospitalization See details
Partial hospitalization services are covered by American Health Advantage of Louisiana (HMO I-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
American Health Advantage of Louisiana (HMO I-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. While transportation is listed as covered, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services and urgently needed services are covered by American Health Advantage of Louisiana (HMO I-SNP) with a 20% coinsurance and no copay, which is waived if you are admitted to the hospital within one day. Worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Primary care benefits under the American Health Advantage of Louisiana (HMO I-SNP) feature no copay and no coinsurance for primary care doctor visits, telehealth, and opioid treatment. Specialist visits, mental health, psychiatric, therapy, and podiatry services are covered with no copay and 0% to 20% coinsurance, while chiropractic services are not covered.
Preventive Services See details
American Health Advantage of Louisiana (HMO I-SNP) partially covers preventive services with no copay and no coinsurance for services like kidney disease education, glaucoma screenings, and in-home support. However, several benefits are not covered, including annual physical exams, fitness benefits, health education, and counseling.
Hearing Services See details
Hearing services under the American Health Advantage of Louisiana (HMO I-SNP) are partially covered, as OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered. Covered routine hearing exams require no copay and 20% coinsurance, while fitting evaluations and up to two prescription hearing aids (up to $500 per ear annually) are provided with no copay and no coinsurance.
Vision Services See details
Vision Services through American Health Advantage of Louisiana (HMO I-SNP) are partially covered, as other eye exam services are not covered. Routine eye exams are covered once yearly with no copay and a 20% coinsurance, and eyewear is covered up to $370 annually with no copays, featuring no coinsurance for eyeglasses and frames but a 20% coinsurance for contact lenses.
Dental Services See details
American Health Advantage of Louisiana (HMO I-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance. Routine preventive and comprehensive dental services, including cleanings, exams, x-rays, and orthodontic treatments, are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by American Health Advantage of Louisiana (HMO I-SNP) with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
American Health Advantage of Louisiana (HMO I-SNP) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
American Health Advantage of Louisiana (HMO I-SNP) covers durable medical equipment, prosthetic devices, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment, supplies, and therapeutic shoes are also covered with no copay and no coinsurance, though prior authorization is required.
Diagnostic and Radiological Services See details
American Health Advantage of Louisiana (HMO I-SNP) covers diagnostic and radiological services with prior authorization, requiring a 20% minimum coinsurance and no copay for radiological services and outpatient X-rays. Diagnostic procedures and tests require a copayment and 20% minimum coinsurance, while lab services feature no copay but are subject to coinsurance.
Home Health Services See details
American Health Advantage of Louisiana (HMO I-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
American Health Advantage of Louisiana (HMO I-SNP) covers Cardiac Rehabilitation Services with no copay, subject to prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
American Health Advantage of Louisiana (HMO I-SNP) covers Skilled Nursing Facility (SNF) services for days 1 through 100 with no copay and no coinsurance, although prior authorization is required. Admission does not require a prior three-day inpatient hospital stay, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are not covered under the American Health Advantage of Louisiana (HMO I-SNP), as acupuncture, over-the-counter items, and meal benefits are all excluded from coverage.
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