Medicaid

	1. What Is Medicaid?

	2. What’s the difference between MediCARE and MediCAID?

	3. How do I know if I am eligible for Medicaid?

	4. Is the Medicaid Eligibility Manual available online?

	5. I am an adult with no income, so why can’t I get Medicaid?

	6. How do I apply for Medicaid?

	7. Are Medicaid application forms available online?

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

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

	10. What are my rights after I apply for Medicaid?

	11. How does Medicaid work?

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

	13. What services does Medicaid cover?

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

	15. How can I find a doctor that accepts Medicaid?

	16. How do I report an address change?

	17. How does the Medically Needy Spend-Down Program work?

	18. How can I find out more about Medicaid?

	19. How do I replace a lost Medicaid card?

Medicaid

	What Is Medicaid?  Back to Top 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.

What’s the difference between MediCARE and MediCAID?  Back to Top 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.

How do I know if I am eligible for Medicaid?  Back to Top 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

	Is the Medicaid Eligibility Manual available online?  Back to Top Yes.  To view the Medicaid Eligibility Manual, click here.

I am an adult with no income, so why can’t I get Medicaid?  Back to Top Parents or qualified relatives may be eligible for Medicaid if they are members of low income families which include a child under age 18 who is deprived of the support of at least one parent. Contact your local Medicaid office or call the Medicaid Hotline toll free at 1-888-342-6207 for more information. If there are no minor children living in the home, Medicaid eligibility for elderly or persons with disabilities with income below the Federal Benefit Rate (FBR) is decided by the Social Security Administration (SSA) through their Supplemental Security Income (SSI) Program. Elderly persons or persons who consider themselves disabled and whose income and resources are below the FBR (currently $564 for an individual and $846 for a couple) should contact the Social Security Administration to apply for SSI.

How do I apply for Medicaid?  Back to Top You (or someone you name) must fill out an application form. You can fill out an application online here or you can get a paper application form from the Medicaid office in the parish where you live, at any of the participating Medicaid Application Centers, or from our Web site by clicking here. A face-to-face interview is not required. The application form with your information can be mailed to your local Medicaid office.

Are Medicaid application forms available online?  Back to Top 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 information do I need to send in with my Medicaid application form?  Back to Top 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.

	Once I apply, what happens to my Medicaid application form?  Back to Top 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?  Back to Top 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 and Hospitals, Bureau of Appeals at P.O. Box 4183, Baton Rouge, LA  70821-4183.

How does Medicaid work?  Back to Top A Medical Eligiblity 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: 1.  he/she is Medicaid eligible on the date the service is received, and 2.  the provider accepts Medicaid, and 3.  the service is covered by the Medicaid Program, and 4.  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.

	Can I be paid back for medical services I have already received?  Back to Top 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.

	What services does Medicaid cover?  Back to Top An online listing of servies is available here. A downloadable document listing services and contacts is available here.

Will Medicaid provide payment for a family member who needs nursing home care?  Back to Top 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 at http://www.dhh.state.la.us/offices/?ID=152 .  The General Medicaid Application Form will not be accepted for Long Term Care applications.

How can I find a doctor that accepts Medicaid?  Back to Top 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 find a listing of primary care physicians (for example, pediatricians, family doctors, general practice doctors) on the CommunityCARE program Web site. Most people with Medicaid who are younger than 65 will be linked to a doctor through this program. Most children in families who qualify for Medicaid are also linked to a primary care doctor through CommunityCARE. However, families who have other private insurance and Medicaid are not part of CommunityCARE. They can still use this Web site to help them find doctors who are active in the Medicaid program. You can also call 1-877-455-9955 toll-free for a listing of specialists (including dentists) 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 can to schedule an appointment.

	How do I report an address change?  Back to Top 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 Mediciaid Online Application page.

How does the Medically Needy Spend-Down Program work?  Back to Top 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.

	How can I find out more about Medicaid?  Back to Top 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 replace a lost Medicaid card?  Back to Top 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 Mediciaid Online Application page.