Learn About Coverage For Medicaid in Louisiana

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UPDATE: In 2020, the rules and steps related to applying for Medicaid are expected to remain the same.

The Louisiana Medicaid coverage program is a federally funded healthcare program that offers health insurance to the residents of Louisiana, based on their resources and income level. How much does Medicaid cost? In general, qualified recipients of Medicaid include low-income households with kids, low-income elderly, and the disabled. However, Medicaid cost estimates will depend on the applicant’s income, status, and medical needs.

In order to obtain Louisiana Medicaid program benefits, you must complete a Louisiana Medicaid application form and be approved by the Department of Healthcare and Family Services. If you are a parent and you have been approved, benefits apply to your children as well.

What services are covered by Medicaid? Some of the health care benefits include preventative care, immunizations, treatment, doctor visits, and screenings. For more information on Medicaid cost estimates in Louisiana and for details on what services and what does Medicaid not cover review the sections provided below:

What Services are Covered by Medicaid in Louisiana?

The Medicaid coverage program of Louisiana covers an extensive range of treatments, equipment, and services that private insurance plans cover. Also, the Medicaid program cover services and treatments to meet particular long-term care needs. The services covered by the Medicaid program are only provided to applicants who meet all the stated Medicaid eligibility requirements. The level of Medicaid services a beneficiary receives depends on family situation, age, transfer of resource requirements and other living arrangements.

What services are covered by Medicaid? The services covered include chiropractic; chemotherapy; Behavioral Health (adults); audiological; ABA (Applied Behavior Analysis); Adult Denture Services; eyeglass services; EPSDT Dental Services; EPSDT Personal Care Services; Early Steps; and Durable Medicaid equipment.

Others are CSoC—Home & Community Based Services Waiver; hospice; home health; outpatient services; emergency room services; inpatient services; hemodialysis services; hearing aids; and Free Standing Birthing Centers. Also, Federally Qualified Health Centers (FQHCs); Family Planning Services in the office of the physician, Family Planning Services (Take Charge Plus); and immunizations are other services covered.

Other Medicaid benefits include lab tests and radiology services; occupational therapy services; nursing facility; nurse practitioners or clinic nurse specialists; midwife services—Certified Nurse Midwife; medical transportation; long Term – Personal Care Services (LT-PCS); and rehabilitation clinic services. Also, other benefits are Psychiatric Hospital Care; Podiatry Services; Physician or Professional Services; Physician Assistants; Physical Therapy; Pharmacy Services; and PACE (Program for All-Inclusive Care for the Elderly).

Other, less popular services that are covered by the Louisiana Medicaid program include STD clinics; rural health clinics; Pediatric Day Health Care (PDHC); Orthodontic Services; optical services; and Speech Therapy & Language Evaluation and Therapy.

What Does Medicaid Not Cover in Louisiana?

While different types of Medicaid insurance cover many medical products and services to low-income families, there is also an extensive range of drugs that is excluded from Medicaid coverage. They include: cough & cold preparations; cosmetic drugs; compounded prescriptions (mixtures of 2 or even more ingredients, the individual drugs will be reimbursed); and anorexics (except orlistat).

Vaccines that are covered in other programs; Non-Legend/OTXC drugs or products with some exceptions; narcotics prescribed purely for narcotic addictions; fertility drugs used for the treatment of fertility; experimental drugs; and erectile dysfunction drugs are among the excluded drugs from coverage.

Other Medicaid excluded drugs include medications that are included in the reimbursement to a facility, for instance, hospitals, mental hospitals; skilled nursing facilities for the recipients who receive benefits under part A of Title XVIII, and any other nursing facilities.

What Does Medicaid Not Cover in Louisiana?

How much does Medicaid cost? Some adults will have to provide a copayment for their prescriptions. In many cases, beneficiaries will not have to pay anything due to their low-income status. Each state has a defined income limit based on the Federal Poverty Level. Below are the Medicaid copay amounts for medications. Medicaid cost estimates can be ascertained when speaking to Medicaid official.

When is a Co-payment not required?

There is no Medicaid copayment required if you are below 21 years of age, pregnant, a federally-recognized Alaskan Eskimo or Native American, living in a long-term care facility or other institution, or receiving emergency medical services.

Medicaid is a health care program which is funded by both the federal and state governments in order to provide low-income residents with low-cost or free health coverage. Because the U.S government now demands that all residents must have health insurance, due to the individual mandate, this program has become essential. Any person or household that is covered by Medicaid meets all the individual mandate requirements of the ACA (Affordable Care Act).