Frequently Asked Questions

What Is Medicaid?

Medicaid is an assistance program that provides medical benefits to low-income persons. Although the Federal government establishes the general rules for the program, specific requirements are actually established by each State. Whether or not you can be eligible for Medicaid depends on the state where you live.  For more information, click here.

How does Medicaid work?

A Medical Eligibility Card is issued to eligible individuals which identifies them as covered by Medicaid.  This card allows a person to receive medical services from a provider if:

  • he/she is Medicaid eligible on the date the service is received, and
  • the provider accepts Medicaid, and
  • the service is covered by the Medicaid Program, and
  • the provider agrees to bill Medicaid for the service and to accept the payment (along with any insurance payment) as payment in full.

Medicaid recipients must always ask the medical services provider about coverage, limitations and/or restrictions before receiving a service.  The card must be shown each time a service is received.

How can I find out more about Medicaid?

You may contact the Medicaid Hotline toll free at 1-888-342-6207 where an agency representative will provide you with answers to your questions.

How do I know if I am eligible for Medicaid?

Individuals who receive Supplemental Security Income (SSI) from the Social Security Administration (SSA) automatically receive Medicaid coverage.

 

Families who get financial help from the Office of Family Support (OFS) through the FAMILY INDEPENDENCE TEMPORARY ASSISTANCE PROGRAM (FITAP) are deemed eligible for Medicaid.

Individuals or families who do not receive SSI or FITAP cash MAY also qualify for Medicaid coverage IF the individual or family belongs to one of the following coverage groups:

  • individuals who are disabled according to the Social Security Administration’s definition
  • individuals who have corrected vision no better than 20/200
  • low income parents of children under age 19
  • children under age 19
  • pregnant women
  • certain women who have been found to need treatment for breast and/or cervical cancer
  • certain individuals who have Medicare

How do I apply for Medicaid?

Are Medicaid application forms available online?

Yes. You can also apply for Medicaid online with the easy to use application located here.  You can use the online application to apply for all Medicaid programs.

If you prefer to apply with a paper application, you can download one of several application forms from this website, by clicking here. If you are unsure which program you want to apply for, complete the General Application, which can be used for any Medicaid program. Fill out, sign, and date the application form, then mail it to the Medicaid office in your area.

What services does Medicaid cover?

A downloadable document listing services and contacts is available here.

What if I am not a U. S. citizen?

Applicants for Medicaid must:
- Provide the State with documentation of citizenship or alien status, and
- Sign a declaration that the applicant is a citizen or national of the United States or an alien in a satisfactory immigration status.

How do I replace a lost Medicaid card?

A replacement Medicaid card can be ordered by calling our toll-free line at 1-800-834-3333 . You may call the LaCHIP hotline at 1-877-252-2447 and choose the "Replace Medicaid Card" option and provide the information required to obtain a replacement Medicaid card through the automated system.  You may also submit your request online at the Louisiana Medicaid Online Application page.

How can I find a doctor that accepts Medicaid?

To get a list of doctors, dentists or other medical service providers in your parish who take Medicaid, please visit our Provider Map page. This page will let you search for Medicaid services in your parish. If there is no doctor listed in your parish, try searching for doctors in your region or in the parishes around yours.

You can also call 1-877-455-9955 toll-free for a listing of specialists in your area who are enrolled and active in the LaCHIP and Medicaid programs.

It is important to remember that not all doctors who are active in the Medicaid program are taking new patients. Be sure to ask the doctor’s office if they are taking new Medicaid patients when you call to schedule an appointment.

How can I report Medicaid Fraud?

There is a form available for reporting Medicaid Fraud. To report fraud of a Medicaid provider or recipient, simply complete the form online with the required information and select the submit button. The form will then be transferred to us for investigating. None of your information is needed to submit a report. Click here to complete a form.

Can I be paid back for medical services I have already received?

You may be paid for medical services received up to 3 months* before you applied if:

  • you are eligible for the date the service was received, and
  • you used a Medicaid provider, and
  • the service is covered by the Medicaid program.

*This does not apply to the LaCHIP Affordable Plan.

How do I report an address change?

To report your address change, contact the Medicaid hotline at 1-877-252-2447 and choose the "Report an Address Change" option and provide the information required through the automated system.  You may also submit your request online at the Louisiana Medicaid Online Application page.

How does the Medically Needy Spend-Down Program work?

Medically Needy provides Medicaid eligibility to qualified individuals and families who may have too much income to qualify for regular Medicaid programs.  Individuals and families who meet all Medicaid program requirements, except that their income is above those program limits, can spend-down or reduce their income to Medicaid eligibility levels using incurred medical expenses.

If I am still waiting for my legal citizenship documents, am I covered?

Illegal aliens and legal aliens otherwise ineligible for Medicaid may be eligible for emergency services and/or emergency labor and delivery services.

Is the Medicaid Eligibility Manual available online?

Yes.  To view the Medicaid Eligibility Manual, click here.

Once I apply, what happens to my Medicaid application form?

A decision will be made and you will be notified within 45 days (with some exceptions) after you apply. If your application is based on disability, it may take up to 90 days. Coverage may start as early as 3 months before the month you apply, if you meet all eligibility factors.

What are my rights after I apply for Medicaid?

If you think the decision we make is unfair, incorrect, or is made too late, you may ask for a Fair Hearing by calling or writing to your local Medicaid office. You may also write directly to Louisiana Department of Health, Bureau of Appeals at P.O. Box 4183, Baton Rouge, LA  70821-4183.

What information do I need to send in with my Medicaid application form?

Each application will tell you what information you need to send in with your application form. We will review your application and information when we receive it. We will let you know if we will need any other information to decide if you qualify for Medicaid benefits.

What doctors accept Medicaid in my area?

Check the provider listing online by clicking here. If you are a member of a Managed Care Plan, use the Provider Search Tool at www.healthy.la.gov.

Where do I go to apply for Medicaid?

Medicaid has over 450 application center sites around the state. Call 1-888-342-6207 to find the site nearest you.

What is “FULL coverage” Medicaid?

Not all Medicaid programs give full coverage.  Full coverage Medicaid is the most complete or total coverage available from Medicaid.  Most medical services should be covered and paid by Medicaid.  If you have questions about what type of coverage you have, please call your local Medicaid office or the Medicaid hotline number at 1-888-342-6207. The 1-888 number is a free call. 

What’s the difference between MediCARE and MediCAID?

The federal government administers Medicare.  Medicare is not based on financial need, but is generally linked to receipt of Social Security benefits based on being age 65 or older or having a disability. 

Medicaid is an assistance program administered on a state-by state basis.  Medicaid eligibility is based mainly on financial need.

Where can I find the Preferred Drug List?

Louisiana Medicaid's Preferred Drug List is available here.

 

Where do I go if I'm pregnant and I have no health insurance?

One resource is the Bureau of Family Health. Visit their website, or call 1-800-251-BABY for more information.

Who can I call for help to complete an application for any Medicaid program?

If you need help to complete the application form or to get any of the needed proof, please call us toll free at 1-888-342-6207.  If you are hearing impaired, you may call the TTY number at 1-800-220-5404.

Who do I call with questions about Medicaid Eligibility?

Medicaid has established an Eligibility Call Center. If you have any questions regarding eligibility please call: Toll-Free 1-888-342-6207 or 1-877-242-2447; Baton Rouge Area 225-342-0555

 

Will Medicaid provide payment for a family member who needs nursing home care?

Louisiana's Medicaid Program provides payment for special long term care support services, as well as full Medicaid health coverage, to eligible people who, because of their medical condition, require assistance with activities of daily living (for example, eating, bathing, dressing, grooming, and transferring).  Long term care supports may be provided either in a facility or in an individual's own home or in the community.  For more information or to download a Medicaid Application for Long Term Care, visit the Medicaid Long Term Care Web site

The General Medicaid Application Form will not be accepted for Long Term Care applications.

Where can I find information about a nursing home's health or fire-safety inspection results?

Health and fire-safety inspections with detailed and summary information about deficiencies found during the 3 most recent comprehensive inspections (conducted annually) and the last 3 years of complaint investigations are found on Nursing Home Compare website.

Nursing Home Compare allows consumers to compare information about nursing homes. It contains quality of care information on every Medicare- and Medicaid-certified nursing home in the country, including over 15,000 nationwide.

Note: Nursing homes aren't included on Nursing Home Compare if they aren't Medicare- or Medicaid-certified. These Nursing Homes can be licensed by the state. For information about Louisiana nursing homes not on Nursing Home Compare, or any other nursing home inquiry contact LDH-Health Standards Section, Nursing Home Program Desk, 225-342-0114, or visit the Nursing Home Internet home page.

Nursing Home providers are required to post the results of their most recent inspection in the facility.

What is a Plan of Correction and how do I obtain a copy of one?

Health care providers licensed, by the Louisiana Department of Health (LDH), or certified for participation in Medicaid or Medicare, by the Centers for Medicare and Medicaid Services (CMS), are inspected, or surveyed, periodically by LDH's Health Standards Section (HSS). Life safety code inspections are performed by State Fire Marshals. HSS also performs complaint investigations.

Deficient practices discovered during the inspection or investigation are "cited" on a form called the Statement of Deficiencies, or SOD.

The provider's plan to correct deficient practices is known as the Plan of Correction, or POC.  The plan must be submitted to the state agency, HSS, within 10 calendar days from the date the facility receives the Statement of Deficiencies, or SOD.

To obtain a provider's POC submit a Public Records Request (PRR) to Health Standards Section.

Please visit HSS' Procedure for Public Records Request (PRR) Internet web page to learn what information is required for a Public Records Request.

Click here to learn more about CMS Statement of Deficiencies and Plan of Correction forms.

Contact Health Standards Section at 225-342-0138 for additional information.