Health Insurance For Low-Income
Medicaid is an assistance program that provides medical coverage to low-income people who meet certain eligibility qualifications. The federal government establishes the general rules for Medicaid with specific requirements being established by each state.
The Louisiana Medicaid Program operates within the Louisiana Department of Health and covers over 1.2 million people. Healthy Louisiana (previously called Bayou Health) is the method whereby most of Louisiana's Medicaid and LaCHIP recipients receive healthcare services. The main goal of Healthy Louisiana is to encourage enrollees to take ownership of their healthcare and the health of their families.
Healthy Louisiana requires you choose a managed care plan and provider for each member of your family who has Medicaid or LaCHIP once you have been notified that you are eligible. The plans differ from one another in multiple ways, including provider networks, referral policies, health management programs, and extra services and incentives offered. Each plan is accountable to the Louisiana Department of Health (LDH). With the introduction of Obamacare (the Affordable Care Act), Louisiana opted to expand their Medicaid programs in 2013. If you were denied Medicaid coverage in Louisiana previous to this expansion, you may now qualify.
Any adult who meets the eligibility criteria listed below will be able to enroll in Medicaid under the expansion.
- Aged 19 to 64 years old
- Has a household income less than 138% of the Federal Poverty Level (FPL)
- Doesn't already qualify for Medicaid or Medicare
- Must meet citizenship requirement
To enroll in expanded Medicaid, it will not be necessary to have a dependent child in your household and there is no asset test.
Louisiana Medicaid Plan Options
Healthy Louisiana requires you choose a managed care plan and provider for each member of your family who has Medicaid or LaCHIP once you have been notified that you are eligible. You will also need to choose a managed care for each member who gets Behavioral Health Services. Here are several options for managed care:
- Aetna Better Health
- Amerigroup RealSolution
- AmeriHealth Caritas
- Louisiana Healthcare Connections
- United Healthcare
Louisiana Medicaid
Louisiana Medicaid provides healthcare coverage to children and families who meet certain income qualifications. Learn more about the following options for Louisiana Medicaid:
LaCHIP
The Louisiana Children’s Health Insurance Program (LaCHIP) provides health coverage to uninsured children up to age 19 that meet household income limits. It is a no-cost health program that pays for healthcare services.
LaCHIP Affordable Plan
The LaCHIP Affordable Plan is a LaCHIP health insurance program for uninsured children in moderate-income families whose income is over the income limits and do not qualify for the regular LaCHIP plan.
Medicaid Purchase Plan
Louisiana's Medicaid Purchase Plan (MPP) offers health coverage for people with disabilities who work. To qualify for MPP, you must have a severe disability that matches Social Security standards, work, be between 16 and 65-years-old, meet income and asset limits, and obtain insurance coverage that is at no cost to you.
Family Opportunity Act Medicaid
Family Opportunity Act Medicaid provides health coverage to uninsured or underinsured children who have disabilities in families that do not meet the income limits, excluding the family from regular Medicaid or LaCHIP. This program allows higher income families to buy into the Medicaid Program.
LaMOMS
LaMOMS provides pay for pregnancy-related services, including doctor visits, lab work, prescription medicines, delivery, and hospital care. It may provide coverage for up to 60 days following the end of your pregnancy.
Take Charge Plus
Take Charge Plus provides health coverage for family planning and family planning related services.
Breast and Cervical Health Program
Through the Breast and Cervical Health Program, women who have been screened and are in need of treatment for breast or cervical cancer or are in a precancerous condition, have access to no-cost health care coverage. The screening must be performed through the Louisiana Breast and Cervical Health Program. LSU Health Sciences Center (LSU HSC) manages this program. Your household income must be below the predetermined Federal Poverty Income Guideline (FPIG) limit to receive the required screening.
Medicaid Long-Term Care Services
Louisiana's Medicaid Program provides coverage for special long-term care support services and full Medicaid health coverage to eligible individuals that require assistance with activities of daily living because of their medical condition. Long-term care support may be provided either in a facility, in an individual's own home, or in the community.
Louisiana's Medicaid Home and Community-Based Services (HCBS)
Louisiana's Medicaid Home and Community-Based Services (HCBS) includes programs administered by both the Office of Aging and Adult Services and the Office for Citizens with Developmental Disabilities.
Medicare Savings Program
The purpose of Medicare Costing Savings programs is to assist individuals in paying their Medicare premiums and by making payments to medical providers for coinsurance and deductibles for Medicare services or by paying Medicare Part B premiums only. Learn more about the programs below.
The Qualified Medicare Beneficiary (QMB) program pays for Medicare Part B premiums, coinsurance, and deductibles for eligible persons enrolled in Medicare Part A.
The Specified Low Medicare Beneficiary (SLMB) program provides payment of Medicare Part B premiums only for individuals who would be eligible for the QMB program, except for excess income. There is also a group known as Qualified Individuals (QI-1).
Medicaid Behavioral Health
All Medicaid members will get their behavioral health services through a Managed Care Organization. Magellan of Louisiana was contracted to manage the Coordinated System of Care, an initiative of the state's four child-serving agencies to provide intensive care management and family-driven, youth-guided services to a small group of children who have complex needs and are in or at-risk of being in out-of-home placements.
LAHIPP (LA Health Insurance Premium Payment) Program
LA Health Insurance Premium Payment (LAHIPP) Program provides financial assistance to families that qualify for healthcare support, despite having insurance through their employer. This program allows the family to begin to increase their long-term health support system while being able to take advantage of Medicaid’s coverage options. To qualify for this program, one person in the family must be qualified for or must be currently using Medicaid.
Louisiana Medicaid FAQs
- What is Medicaid?
Medicaid is a state funded insurance that that provides coverage to low income families, pregnant women, newborns, and children that may not be able to afford to purchase their own care.
- Who is eligible for Medicaid?
The following groups are eligible for Louisiana Medicaid:
- Children 0-18 years with a household income less than 212% of the Federal Poverty Limit (FPL);
- Children 0-18 years with a household income between 212-250% of the FPL would be part of LaCHIP;
- Pregnant women with a household income less than 133% of the FPL;
- Parents with dependents with a household income less than 19% of the FPL.
- How do I find out if I am eligible for Medicaid?
To find out if you are eligible for Medicaid, you must fill out an application for Medicaid or CHIP. You may fill out an application at any time of the year. See more on Medicaid.
- Will Medicaid cover my children?
Your household income level will determine if your child or children can be covered by Medicaid.
- What is CHIP?
CHIP is a program that supports children in families that cannot afford private health insurance, but whose household income is too high to qualify for Medicaid.
- Does Medicaid satisfy the health insurance requirement?
Yes, Medicaid will satisfy the Affordable Care Act (Obamacare) health insurance requirement for the covered individuals.
- What information and documents should I have when I'm signing up for Medicaid?
Depending on the Medicaid program being applied for, you will need the following: Identity, Social Security, proof you live in Louisiana, proof of income, proof of medical costs, and bank account information.
- How does Obamacare work with Medicaid?
Louisiana Medicare has expanded its coverage with the signing of Obamacare, the Affordable Care Act, to include more wellness visits, health screenings, and other preventive care services.
Sources: