Welcome to LA HAP!

What is LA HAP?

Louisiana Health Access Program

L-DAP: MedicineHIP: Insurance premiums and

cost-shares

A part of the Ryan White program

How do I apply?

• LA HAP application: www.lahap.org• Do application every 6 months– No health insurance? LA HAP pays for medicine– Have health insurance? LA HAP pays for

medicine AND premiums, doctor visits

LA HAP works with your health insurance. LA HAP is NOT health insurance.Do you want health insurance?

1) Shop for, sign up for health insurance

2) Do LA HAP application

5) Ramsell sends you a “LA HAP card”

3) Insurance company sends you a “Schedule of Benefits” and an insurance card

4) Send your insurance plan information to LA HAP

Open and save EVERYTHING!

Open and read now = Less problems, less bills later

LA HAP

•Copy of LA HAP application•Copy of HIP approval letter (ask your case manager)•Copy of LA HAP card (for getting medicine)

Insurance

•Schedule of Benefits (SOB)•All Explanations of Benefits (EOBs)•Copy of insurance card

Doctor•Medical information•Prescription information•Every bill you get

Bring: insurance card

Bring: Insurance card, LA HAP card

Before you go to the doctor (1)• Will I have to pay?

LAHAP CAN pay for… LAHAP CANNOT pay for…

Most medicinesErectile dysfunction drugs, nutrition supplements, OTC drugs, cosmetic

drugs

Doctor visits In-patient hospital stays

Lab work Discount health/pharmacy plans

Dental premiums Dental cost-shares

Vision premiums and services IF they’re part of a bigger health plan

Vision premiums and cost-shares if they’re part of their own plan

Tests Products or services your insurance company doesn’t cover

Before you go to the doctor (2)• Does my insurance cover it too?– Look in your SOB, or– Call your insurance company.

Make sure BOTH LA HAP and the insurance company cover it.

Before you go to the doctor (3)

• Call them to explain what HIP is.• They can call HIP at 225-927-1269 and ask to

speak to Katie. She can explain what HIP is.• The doctor should bill HIP for any “cost-

shares”: co-pays, coinsurance, deductibles.

At the doctor’s office

• A deductible is the money you (or HIP) have to pay before your insurance company will start helping with costs.– Your SOB will tell you what your deductible is.– Example: you have a deductible of $2000. That

means that each year, you (or HIP) have to pay $2000 of your own money at the doctor’s office before your insurance company starts paying.

At the doctor’s office (2)

• A co-pay is the money you (or HIP) pay the doctor/pharmacy the day of your visit.

• For example, a doctor might ask you to pay $20 for a visit, and then they will send a bill to the insurance company for the rest.

At the doctor’s office (3)

• Co-insurance is a part of the total bill you (or HIP) pay to the doctor/pharmacy the day of your visit.

• For example, a pharmacist might ask you to pay 20% of the cost of a drug, and then they will send a bill to the insurance company for the rest.

At the doctor’s office (4)

• Ask questions.• Bring a friend or family

member if you like.• Ask when you should come

back.• Did you like your doctor? If

not, you can choose a different one.

After your visit

1) Doctor sends bill to insurance company2) Insurance company pays bill3) Insurance company sends you an EOB

(“Explanation of Benefits”)4) If your insurance company didn’t pay the

whole bill, your doctor may send you a bill too.

5) Call HIP (225-927-1269) about this bill and ask if they can help.

Remember!

• If you have questions, ask!– About using your insurance: the insurance company– About your LAHAP application: LAHAP at 504-568-

7474– About a bill: your doctor, or HIP at 225-927-1269.

• Be patient!– Sometimes things can be slow.– You can call if you think something’s wrong.

• Open your mail and save everything!

Always politely! People will try

harder to help you!

Thank you!

Alicia Cooke504-568-7428alicia.cooke@la.gov

Questions? Call me!