Magnolia Local
Overview
The Magnolia Local plan is a select, In-Network provider only plan for members who live in specific coverage areas. Magnolia Local is a health plan for members who want local access, affordable premiums and a new approach to healthcare. Out-of-Network care is covered only in emergencies, and the member may be balance-billed.
What is different about Magnolia Local?
- Your network of doctors and hospitals is more defined than other plans. You still have a full network of primary care doctors, specialists and other healthcare providers in your area.
- You have a coordinated care team that talks to one another and helps you get the right care in the right place.
- Staying in network is very important! Out-of-network coverage is provided only in the case of an emergency
- Where you live will determine which Magnolia Local network you will use.
Before choosing Magnolia Local, consider the following
- Which doctors/clinics do you go to the most?
- Which clinics/hospitals are closest to where you live?
- Staying in network is very important! As long as you receive care within your network, you will pay less than if you receive care outside of the network.
Magnolia Local Networks
Community Blue
A select, local network designed for members who live in the parishes of Ascension, East Baton Rouge, Livingston, and West Baton Rouge.
Blue Connect
A select, local network designed for members who live in the parishes of Acadia, Bossier, Caddo, Evangeline, Iberia, Jefferson, Lafayette, Orleans, Plaquemines, St. Bernard, St. Charles, St. James, St. John the Baptist, St. Landry, St. Martin, St. Mary, St. Tammany, Terrebonne and Vermilion.
Healthcare Providers
Our networks provide access to many healthcare providers depending on your region
Community Blue (Baton Rouge)
Baton Rouge Region: Baton Rouge General Medical Center • The Baton Rouge Clinic* • BR General Physicians Group Ochsner Medical Center Baton Rouge • Ochsner Clinic • Ochsner The Grove
To find a complete list of providers in this network, visit the LABlue website and choose your member type under Magnolia Local. Click Find a Doctor, then Find a Community Blue Doctor.
*Select physicians available at The Baton Rouge Clinic. Does not include gastroenterologist physicians.
Blue Connect (New Orleans, Northshore, Lafayette, Bayou and Shreveport/Bossier Regions)
Greater New Orleans/Bayou Regions: Ochsner Health and its affiliates • Leonard J. Chabert Medical Center • Terrebonne General Medical Center
Lafayette Region: Ochsner Lafayette General and its affiliates • Abbeville General Hospital • Opelousas General Health System • Iberia Medical Center • Ochsner Abrom Kaplan Memorial Hospital
St. Tammany Region: Ochsner Medical Center Northshore • Slidell Memorial Hospital • St. Tammany Hospital System
Shreveport/Bossier Region: CHRISTUS Shreveport-Bossier Health System and its affiliates
To find a complete list of providers in this network, visit the LABlue website and choose your member type under Magnolia Local. Click Find a Doctor, then Find a Blue Connect Doctor.
*Providers in the Community Blue and Blue Connect networks are subject to change. To view Louisiana Blue’s network providers, visit the groupbenefits website.
| Active employees and Non-Medicare Retirees (retirement date ON or AFTER 3-1-2015) | Employee Only | Employee + 1 | Employee + 2 or more |
|---|---|---|---|
| Deductible (In-Network) | $400 | $800 | $1,200 |
| Deductible (Out-of-Network) | No coverage | No coverage | No coverage |
| Out-of-pocket max (In-Network) | $2,500 | $5,000 | $7,500 |
| Out-of-pocket max (Out-of-Network) | No coverage | No coverage | No coverage |
| Copay (In-Network) PCP/SPC | $25 / $50 | $25 / $50 | $25 / $50 |
| Non-Medicare Retirees BEFORE 3-1-2015 | Employee Only | Employee + 1 | Employee + 2 or more |
|---|---|---|---|
| Deductible (In-Network) | $0 | $0 | $0 |
| Deductible (Out-of-Network) | No coverage | No coverage | No coverage |
| Out-of-pocket max (In-Network) | $1,000 | $2,000 | $3,000 |
| Out-of-pocket max (Out-of-Network) | No coverage | No coverage | No coverage |
| Copay (In-Network) PCP/SPC | $25 / $50 | $25 / $50 | $25 / $50 |
Pharmacy Benefits
OGB uses a Formulary to help members select the most appropriate, lowest-cost options. The Formulary is reviewed regularly to reassess drug tiers based on the current prescription drug market. Members will continue to pay a portion of the cost of their prescriptions in the form of a copay or coinsurance. The amount members pay toward their prescription depends on whether or not they receive a generic, preferred, non-preferred, or specialty brand drug.
| Tier | Member Responsibility* |
|---|---|
| Generic | 50% up to $30 |
| Preferred | 50% up to $55 |
| Non-Preferred | 65% up to $80 |
| Specialty | 50% up to $80 |
| After the out-of-pocket threshold amount of $1,500 is met by you and/or your covered dependent(s): | |
| Generic | $0 copay |
| Preferred | $20 copay |
| Non-Preferred | $40 copay |
| Specialty | $40 copay |