Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives

211 - Get Connected. Get Answers.

Apply for health coverage or renew existing coverage

Apply or renew coverage online at Louisiana Medicaid Online Services.

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Paper Application and Forms

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Application for Health Coverage

Use this form to apply for or renewal coverage for all Louisiana Medicaid programs.  Also use this form to apply for help paying for health insurance through the Health Insurance Marketplace.

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Extra Person Page

If you have more than 4 people in your home, use these pages to tell us about them.

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Employer Coverage Tool

If you get insurance through someone's job or if you can get insurance through a job, get your employer to fill out this form so you can tell us about it. 


Medicare Savings Program Application

Use this form to apply for assistance with your Medicare premium.


Long Term Care Application

Use this application for persons who are planning to live or now live in a nursing facility, group home, or developmental center in Louisiana or who have been offered an opportunity for Waiver or PACE in Louisiana.