Insurance enrollment & paying for care

Cost should not be a barrier to your health care. Your out-of-pocket cost for services will vary based on the services provided, insurance status, income and household composition, and other factors.

Many insurance companies contract with CrescentCare, but some insurance companies do not. For example, Ochsner plans and People’s Health do not contract with CrescentCare. (A more complete list is below). If you have an insurance plan that is out-of-network, we will refer you to a provider that is contracted with that insurance company. If you do not know if we are contracted with your insurance company, please call us.

We offer a sliding discount on fees for CrescentCare services to people whose household income is at or below 200% of the federal government’s Poverty Guidelines (updated annually). You must provide proof of income to qualify for the sliding discount program. We strongly recommend that you bring in proof of income to your visit. The purpose of this program is to assist individuals who are uninsured or underinsured.

CrescentCare defines family/household as individuals who describe and present themselves as a family for services, regardless of actual or perceived marital status, sexual orientation, or gender identity. A family may be a group of related or unrelated persons who share living arrangements, expenses, and income.

Insurance Plans

Check these lists to find your insurance plan. The following are a list of the most common insurance plans that are contracted with CrescentCare. Please note that this is not an exhaustive list. If your insurance plan does not show up on the following list, we recommend that you reach out to our staff to confirm whether or not we are in network with your insurance.

• Aetna
• Aetna Better Health
• AmeriHealth Caritas
• BCBS Blue Advantage
• BCBS HMO
• BCBS Medicare
• BCBS Medicare Advantage
• BCBS PPO
• BCBS Signature Blue
• Cigna
• Coventry
• Gilsbar
• Healthy Blue (BCBS Medicaid)
• Humana Commercial
• Humana Medicare
• Louisiana Healthcare Connections
• Optum Behavioral Health
• Peoples Health
• Tricare
• United Behavioral Health
• United Healthcare
• United Healthcare Medicaid
• United Healthcare Medicare
• Medicare Part A
• Medicare Part B
• Vantage
• Wellcare

Many insurance companies have contracted with CrescentCare. Unfortunately, the insurance companies listed below do not contract with CrescentCare. We recommend that you call the number on the back of your insurance card for more information.

BLUE CROSS BLUE SHIELD
888-630-2583 / TTY 711

• Blue Connect (Ochsner)
• Community Blue Network (Shreveport and Baton Rouge only)
• OGB Magnolia Local

HUMANA
844-236-5436 / TTY 711

• Humana Total Care Advantage HMO
• Humana Ochsner HMO
• Humana HMO Gold Plus SNP
• Humana Ochsner Tier 1 (CrescentCare Medical Plan)

If you don’t have insurance, we can help you enroll.

We believe that cost should not prevent you from getting the care you need.

CrescentCare can help patients with enrollment in the Medicaid, Medicare, or the federal marketplace for health insurance coverage. CrescentCare is certified with the state of Louisiana as a Medicaid Application Assistance Center.

If you do not qualify for Medicaid, you may enroll in the federal marketplace for health insurance coverage. We partner with Pride Life, an insurance broker, who can assist patients with marketplace insurance. Please call Pride Life at (225)-228-1515 or visit their website at https://www.pridelife.net/services-products/health-insurance/

CrescentCare offers a sliding discount fee program on our services to people who qualify for the program. This means that people who have less income pay less towards their care. You can view the sliding fee discount charts here.

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Payment FAQ

I’m sick and I haven’t seen a doctor because I’m afraid of what it’s going to cost. What should I do?

We believe that cost should not prevent you from getting the care you need. If you do not have insurance, we will review your options, including enrolling in Medicaid or eligibility for our sliding fee scale. Please note, if you have insurance, please confirm that we accept your insurance. If you are a new patient, we will only schedule an appointment if you have an insurance plan we accept.

What is care going to cost?

Your costs will vary based on the services provided, your insurance, your income, the composition of your household, and other factors.

CrescentCare offers a sliding discount fee program on our services to people who qualify for the program.

Can I get an estimate?

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance (“self-pay” patients) an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 887-696-6775

You may also be eligible for the sliding fee discounts on your portion of the balance (co-pay or deductible), even if you have insurance. Please note, if you have more than one appointment in the same day, you may have two separate copays.

I don’t have any insurance. What do I do?

We strongly recommend that you see if you are eligible for insurance. Insurance helps cover the costs of visits and medications. Louisiana expanded Medicaid in 2016, and most citizens below 133% of the Federal Poverty level are eligible for Medicaid. If you would like assistance in enrolling in Medicaid, please call this number 504-821-2601 to make an appointment. CrescentCare is certified with the state of Louisiana as a Medicaid Application Assistance Center.

If you do not qualify for Medicaid, you may enrolling in the federal marketplace for health insurance coverage. We partner with Pride Life, an insurance broker, who can assist patients with marketplace insurance. Please call Pride Life at 225-228-1515 or visit their website at https://www.pridelife.net/services-products/health-insurance/

What’s a sliding discount? How does it work?

This means that people who have less income pay less towards their care. If you qualify for the sliding fee discount program, the lower your household income, the less you will pay towards your care. You must provide proof of income to qualify.

You can view the sliding fee discount charts here.

The goal is to make sure that cost is not a barrier to care for people who cannot afford it and who qualify based on the program rules.

Who qualifies for the sliding fee discount program?

You may qualify for a discount if your family/household income is at or below 200% of the federal government’s Poverty Guidelines and you provide proof of income.

What do you mean by family or household?

We define family as individuals who describe and present themselves as a family for services, regardless of actual or perceived marital status, sexual orientation or gender identity. A family may be a group of related or unrelated persons who share living arrangements, and share expenses and income.

What are the poverty guidelines?

Every year the Federal Department of Health and Human Services (HHS) in Washington D.C. releases the poverty guidelines for administrative purposes – for instance, to determine financial eligibility to qualify patients to be eligible to pay reduced costs for services.

What do I need to bring in to qualify for the sliding fee scale discount program?

Please bring proof of income for each member of your household with you to your appointment. If you do not provide proof of income at your first visit, then you will have 30 days to provide proof of income. If you do not provide proof of income, then you will be responsible for the full charge of the visit.

Does CrescentCare offer free care?

CrescentCare is a federally qualified health center. We receive some grant funding to provide care to our community at rates that our patients can afford. It is not free care.

What if my insurance doesn’t cover everything?

Please be aware that some of the services you receive may not be covered-or not considered reasonable or necessary-by your insurance. You must pay for these services at the time of your visit, unless arrangements such as a payment plan have been made.

What if I do not want the services to go through my insurance company?

If you do not want to bill your insurance for services we can still see you. You will be considered self-pay and are responsible for the full charge of the visit and any lab costs.

How do I know if the services are covered before I receive them?

Our goal is to ensure we have good communication with you about the services we provide to you. Our highly trained medical professionals determine what is medically necessary and reasonable. If there are questions, our staff will discuss this with you. Your insurance company may need to be contacted to see if services are covered. Please talk to our staff for more information.

Do all services at CrescentCare qualify for the sliding fee scale?

CrescentCare offers all medical, dental, and behavioral health on a sliding fee scale. The scales and discounts for dental, behavioral health, and medical care are different.

What if I don’t want to accept a service unless it is covered by my insurance? Will I be given the opportunity to opt out of treatment that is not covered before I receive it?

You can always opt out of treatment. If you are concerned about a service not being covered by your insurance, please talk to your provider and our staff.

What if I receive treatment that is not covered by my insurance, and I cannot afford it?

If your insurance company does not pay your claim, the balance will automatically be billed to you. Payment plans are available upon request.

What kind of payment plan? How do I request it?

Payment plans allow you to pay your balance overtime in more manageable amounts. Please see one of our staff to work out the details.

What about lab work?

If you have insurance, your labs will be billed directly to your insurance plan by the lab company. The lab company will bill you directly for any costs your insurance does not cover. If your household income is below 200% of the Federal Poverty Level (see the chart below), lab costs are included in your visit cost.

What if I do not qualify for the discount and do not pay my bill?

CrescentCare will work with you to develop a payment plan. CrescentCare retains the right to send patients who refuse to pay to collections.

I’m confused about costs and insurance. Who can I talk to?

If you have questions, please call 504-821-2601 and we’ll do our best to answer your questions.

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Payment & Deductibles

If you have insurance, all applicable co-payments and deductibles must be paid at the time of service. You may be eligible for the sliding fee discount on your portion of the balance, even if you have insurance. Please note, if you have more than one appointment in the same day, you may have two separate copays. Please be aware that some of the services you receive may not be covered-or not considered reasonable or necessary-by your insurance. You must pay for these services at the time of your visit, unless other arrangements have been made. If your insurance company does not pay your claim, the balance will automatically be billed to you. Payment plans are available upon request.

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Definitions

OUT OF POCKET MAXIMUM: The total payments toward eligible expenses that a covered person funds for him/herself and/or dependents.

These expenses may include deductibles, co-pays, and coinsurance as defined by the contract. Once this limit is reached, benefits may increase to 100% for health services received during the rest of that calendar or policy year.

Deductibles may or may not be included in out-of-pocket limits

DEDUCTIBLE: The amount of eligible expenses a covered person must pay each year from his/her own pocket before the plan will begin to pay for eligible benefits.

COPAYMENT: Co-payment is a payment that must be made by a covered person at the time of service. Services that require co-pay, and the predetermined amount payable for each service, are specified in the insurance policy. Co-payments may be required for physician visits.

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Labs

If you have insurance, your labs will be billed directly to your insurance plan by the lab. The lab company will bill you directly for any costs your insurance doesn’t cover. If your household income is below 200% of the Federal Poverty Level (you can check that here), lab costs are included in your visit cost. We can still see you for services even if you do not want us to bill your insurance for services. You will be responsible for all billed fees. If you need lab services, the lab company will bill you directly.