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Louisiana Medicaid


In Louisiana, the state provides health insurance to low-income individuals and families through Medicaid programs, funded by taxes and the federal government. These programs are designed to help those who cannot afford to buy a health plan and provide them access to the services they need, whether they are pregnant, disabled, have a special health need, or are in relatively good health. The Medicaid program mainly serves Louisiana children under 19, as the income limits are more accepting for young people. An estimated 1.2 million Louisianians are covered by the program, also including parents, blind persons, adults age 65 and older, Medicare beneficiaries, and women with breast or cervical cancer.

Medicaid is administered by the Louisiana Department of Health and Hospitals, and several health plans facilitate the care of those enrolled in an MCO. The program is free for those who qualify, with numerous services to accommodate any serious or mild medical concern. Benefits include a full range of federally and state mandated services, on top of those that are considered essential for the program. Preventive care, physician services, and hospital care are all included at no cost. As each member is different, the eligibility category in which you are placed will determine the benefits you receive. The State Children’s Health Insurance Program (SCHIP) is also operated under Medicaid, and offers full benefits to children with family income over the Medicaid limits.

 

Louisiana Medicaid Eligibility

The Louisiana Department of Health and Hospitals decides who qualifies for each Medicaid program by state and national residency, income, and disability status. You must be a resident of Louisiana, and have legal citizenship in the United States in order to qualify. Earnings are evaluated by the amount of people you live with and related to the Federal Poverty Level. Each category has its own income guideline to follow. Income includes both what you have earned and Social Security Disability payments, and for SSI beneficiaries, their SSI income is counted Рthey are also automatically qualified for the program.

 

Current Federal Poverty Guideline

 

Pregnant Women 200%

Family of 2: $2,522 monthly, $30,260 yearly

Family of 3: $3,182 monthly, $38,180 yearly

Family of 4: $3,842 monthly, $46,100 yearly

Family of 5: $4,501 monthly, $54,020 yearly

 

Children Ages 0-5 133%

Family of 1: $1,238 monthly, $14,856 yearly

Family of 2: $1,639 monthly, $19,699 yearly

Family of 3: $2,068 monthly, $24,817 yearly

Family of 4: $2,497 monthly, $29,965 yearly

 

Children Ages 6-19  100%

Family of 1: $938 monthly, $11,170 yearly

Family of 2: $1,260 monthly, $15,130 yearly

Family of 3: $1,590 monthly, $19,090 yearly

Family of 4: $1,920 monthly, $23,050 yearly

 

Parent (unemployed) 11%

Family of 1: $102 monthly, $1,229 yearly

Family of 2: $139 monthly, $1,664 yearly

Family of 3: $175 monthly, $2,100 yearly

Family of 4: $211 monthly, $2,536 yearly

 

Parent (employed) 25%

Family of 1: $233 monthly, $2,793 yearly

Family of 2: $315 monthly, $3,783 yearly

Family of 3: $398 monthly, $4,773 yearly

Family of 4: $480 monthly, $5763 yearly

 

Single Aged, Blind, or Disabled 75%

$698 monthly, $8,377 yearly

*$2,000 Asset Limit

 

Couple Aged, Blind, or Disabled 83%

$1,046 monthly, $12,558 yearly

*$3,000 Asset Limit

 

Qualified Medicare Beneficiaries (QMB) 100%

Medicaid covers your premiums, coinsurance, and deductibles.

Single: $938 monthly, $11,170 yearly

Couple: $1,260 monthly, $15,130 yearly

 

Specified Low-Income Medicare Beneficiaries (SLMB) 120%

Medicaid covers your premiums only.

Single: $1,117 monthly, $13,404 yearly

Couple: $1,513 monthly, $18,156 yearly

 

 

Covered Benefits

Services vary based on the specific Medicaid program and beneficiary, as some are disabled and entitled to nursing care, or children who receive access to more types of services to ensure they grow up healthy. Regardless of the program, any medical needs you have will be likely be covered. Below are some of the services offered to various members of Medicaid.

  • Adult dentures (21 and older)
  • Audiology (under age 21)
  • Chemotherapy
  • Chiropractic services (under age 21)
  • Dental care (under age 21, limited for pregnant women)
  • Durable Medical Equipment
  • EarlySteps: infant and toddler early intervention services
  • EPSDT screenings, dental, medical, psychological services (under age 21)
  • Emergency care
  • Eye care, exams, glasses
  • Family planning
  • Federally Qualified Health Centers
  • Home Health Care
  • Hospice
  • Inpatient and outpatient hospital
  • Laboratory and X-ray
  • Long term care
  • Maternity care
  • Medical transportation
  • Mental health care
  • Midwife services
  • Multi Systemic Therapy
  • Pediatric day health care
  • Pharmacy
  • Physician services
  • Substance abuse services
  • Waiver programs

 

Managed Care

Many Medicaid members select a managed care organization upon approval, which connects you to an insurance provider and a primary care doctor who oversee your medical needs. By choosing a health plan and a PCP, you connect to a specific network of doctors and hospitals to receive services. Depending on where you live in the state, various health plans create an opportunity to have a simply communicated, efficient care delivery system. The following are the health plans offering Medicaid coverage in Louisiana, many of whom are the same carriers offering coverage to individuals and families on the private market.

  • Aetna Life Insurance Company (LA)
  • Connecticut General Life Insurance Company (LA)
  • Coventry Health Care of Louisiana
  • DHH Medicaid
  • Group Health Incorporated
  • HMO Louisiana Inc. (BCBSLA)
  • Humana Health Benefit Plan of Louisiana
  • Louisiana Health Service & Indemnity Company d/b/a BCBSLA
  • UnitedHealthcare Insurance Company (LA)
  • UnitedHealthcare of Louisiana

There is also a new managed care program called Bayou Health, with health plans who are accountable to the Department of Health & Hospitals and the state.

 

How to Apply

Louisiana Medicaid accepts multiple methods of application, including online, by mail, and at Medicaid Application Centers throughout the state. If you need assistance filling out your form, you may contact the Medicaid hotline at 888-342-6207. For those downloading a paper application, you must select the specific program for which you wish to apply, as there are different applications for different groups. You may also contact your local Medicaid office for help with completing your form.

Apply for Louisiana Medicaid Online

Download a paper application here.

Mail or fax all completed Medicaid forms to:

P.O. Box 91278

Baton Rouge, LA 70821-9278

Fax: 877-523-2987

 

Resources

Louisiana Medicaid

Apply Online

Contact Medicaid:

888-342-6207

 

 

 

Sources:

 

1. Louisiana Department of Health & Hospitals. “About Medicaid.” http://dhh.louisiana.gov/index.cfm/page/220/n/20.

2. Kaiser State Health Facts. “Medicaid & CHIP – Louisiana.” http://www.statehealthfacts.org/profileind.jsp?cat=4&rgn=20.

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