Who Is Eligible For Medicaid
The general guidelines for eligibility for Medicaid are set by the Federal government however, each state sets up their own specific requirements for eligibility and these can differ from state to state.
All States are required to include certain individuals or groups of people in their Medicaid plan.
The state eligibility groups are:
- Categorically needy
- Medically needy
- Special groups
In the categorically needy group, this will cover pregnant women whose income level is at or below 133% of the Federal Poverty level.
In the medically needy group, this will cover a pregnant woman who makes too much money to qualify in the categorically needy group. This means that women, who may have been denied Medicaid before, may be able to qualify now.
Sign Up For Our Weekly Newsletter
Portland, Maine Office:
- Make more effective use of data, data matching, and demonstrating return on investment :
- Review Medicaid data on individuals with intellectual and/or developmental disabilities to identify those eligible for additional housing supports.
- Create data sharing agreementsto share data among Medicaid, I/DD, mental health, and housing
- Illinois Department of Human Services
- Illinois Department of Healthcare and Family Services
- Illinois Housing Development Authority
- Illinois Council on Developmental Disabilities
- Continue review of health and hospital projects for potential state system data matching and housing initiative opportunities.
- Continue work on pre-tenancy and tenant supports for Illinois residents.
- Explore expansion or new avenues for services typically covered through Medicaid Section 1115 waivers for other populations, especially I/DD populations.
From 2016 to 2018, she was the Chief Health Policy Advisor in the Office of Lt. Governor Nancy Wyman, coordinating the states health reform initiatives.
Helping You Have A Healthy Baby: Benefits For Pregnant Women
Pregnancy is an exciting time as an expectant mom, you have lots to do to get ready for the arrival of your baby! Louisiana Healthcare Connections is here to help you have a healthy pregnancy with special benefits and services for you and your baby.
In addition to full pregnancy healthcare coverage and unlimited visits to your OB/GYN, pregnant members enjoy the following special benefits:
START SMART FOR YOUR BABY
As a Louisiana Healthcare Connections member, you can enroll in our Start Smart For Your Baby program. This program is free to pregnant members and new moms. Youll get tips on how to have a healthy pregnancy and reminders for prenatal and postpartum care in the mail and by phone.
REWARDS FOR COMPLETING PRENATAL AND POSTPARTUM VISITS
Louisiana Healthcare Connections members get rewards for completing certain doctor visits and screenings. These cash rewards are added to a My Health Pays card. Your rewards are your dollars to spend to help pay for utilities, transportation, telecommunications childcare services, education costs and rent. And only you know the best way to spend them. My Health Pays rewards can be used They can also be used to buy home goods, personal care items, clothing, food and more at participating stores.
For pregnant and new moms, the rewards include the following:
Your baby can also earn rewards! For completing well-child visits at 2, 4, 6, 9, 12 and 15 months, your little one receives $30! Learn more about our Member Rewards Program.
Also Check: Does West Virginia Have Expanded Medicaid
How Louisiana Slashed Medicaid Funding For Pregnant Women And Blamed A Typo
Over the last several months, the Louisiana Department of Health and Hospitals made a series of announcements about LaMOMS, the states Medicaid program for pregnant womenfirst announcing cuts to the program, then a plan to reevaluate those cuts, and then that the cuts were being rescinded. Health Secretary Kathy Kliebert explained in a series of interviews with the Baton Rouge Advocate that this seesaw of decisions was caused by an unspecified change in federal policy related to the Affordable Care Act .
The $11 million in cuts, which passed as part of the 2013-2014 state budget in June, were added back into the budget in November. But the reversal dictated that the category of women who were slated to be dropped from LaMOMS are now instead covered through the states Medicaid program for children, LaCHIP. This means that the Medicaid funds are now technically for unborn children, not for the pregnant women themselves, and these women will lose postpartum care coverage. These changes went into effect in January.
When Louisiana officials discovered their mistake, they blamed the mixup on the Federal Centers for Medicare and Medicaid Services , the department that oversees ACA implementation.
If You Experience/require Frequent Trips To The Emergency Room We Are Here To Assist
If you received ER care, a Care Manager will follow up with you after your ER visit to offer assistance with discharge instructions, educate you on appropriate use of the ER versus an urgent care center, and assist with scheduling follow up appointments to keep you healthy.
Benefits of this program are as follows:
- You have an assigned PCP and have an appointment for follow-up and maintenance care.
- You are educated on how and where to seek appropriate level of care.
- You are provided contact information for the Nurse Call Line, and participating Urgent Care Centers/Minute Clinics.
- You are provided education on available transportation services.
- You are connected to the Community Care Management Team, Care Coordination, Complex Care Management and Community Health Navigators.
Don’t Miss: How Do I Pay My Medicaid Spend Down
New Medicaid Eligibility And Enrollment System Launched In November 2018
In November 2018, Louisiana rolled out a new Medicaid eligibility and enrollment system that allows for real-time eligibility determinations using data from state and federal systems, instead of relying on manual eligibility determinations. And under the new system, enrollees would no longer receive phone calls from Louisiana Medicaid when their coverage is up for renewal notices and requests for additional information would be sent by mail instead, and the system was set up to require enrollees to provide updated information in a timely manner in order to avoid termination of their coverage.
However, in August 2019, the state temporarily suspended the program that would terminate Medicaid coverage for people who dont respond to requests for updated information. And when the COVID pandemic began several months later, Medicaid eligibility redeterminations ground to a halt nationwide. The Families First Coronavirus Response Act, enacted in March 2020, provides states with additional federal Medicaid funding, but on the condition that enrollees cannot have their coverage terminated for the duration of the COVID public health emergency .
How Can I Determine If I Qualify For Medicaid
Qualifying for Medicaid is not as black and white as qualifying for most other government programs. Most government programs have some basic requirements along with very clear income guidelines to help individuals know if they qualify.But Medicaid has many ways that someone can qualifyand even though income makes up part of the eligibility requirements, it is not solely based on that. Even people with the lowest incomes may not qualify for Medicaid if they do not fall into one of the Medicaid groups.
And people who make a middle-range income may qualify if they fit one of the qualifying groups and can fall back on options such as share of cost
If you are pregnant and uninsured, Contact your local Medicaid office to find out if Medicaid is the right option for you.
Compiled using information from the following sources:
1. US Government Information
Don’t Miss: Dentist That Take Straight Medicaid
The Requested Url Could Not Be Retrieved
The following error was encountered while trying to retrieve the URL:
Unable to determine IP address from host namewww.singlemom.com
The DNS server returned:
Server Failure: The name server was unable to process this query.
This means that the cache was not able to resolve the hostname presented in the URL. Check if the address is correct.
Your cache administrator is .
Generated Fri, 12 Aug 2022 12:14:26 GMT by host
Louisiana Can Improve Maternal Health Outcomes Through Medicaid
Louisiana is facing a maternal health crisis. Our state has among the highest maternal death rates in the nation with Black and Brown women experiencing pregnancy-related death at three times the rate of white women. Our state is one of eight to receive an F grade on the 2020 March of Dimes Report Card. The number of preterm births and infant deaths has increased in recent years, reversing some years of gains.
Fortunately, there are positive policy actions we can take now to help reverse harmful trends and enable more mothers and babies to thrive after birth. We can extend postpartum coverage to 12 months through our state Medicaid program, which has an important role to play in addressing our maternal health crisis.
More than half of Louisiana births are covered by Medicaid. And, while babies remain covered by Medicaid and LaCHIP during their first year of life, mothers are less certain to remain covered and many face disruptions in care during one of the most vulnerable times in their lives.
We can help Louisiana moms this Mothers Day by following the lead of other states in extending Medicaid postpartum coverage from 60 days to 12 months. Research shows that continuous health insurance coverage leads to better health care access and better health outcomes for both moms and babies.
Also Check: List Of Oral Surgeons That Accept Medicaid
The Long Path To Medicaid Expansion
On November 21, 2015, Democrat John Bel Edwards won the runoff gubernatorial election in Louisiana. Edwards supported Medicaid expansion as called for in the ACA, and his win immediately made Medicaid expansion much more likely in Louisiana.
Former Governor Bobby Jindal was emphatically opposed to Medicaid expansion, but was not eligible to run in the 2015 gubernatorial race due to term limits. There was a primary election in October 2015, but none of the four candidates received a majority of the vote. So a runoff election was scheduled for November 21, 2015, with voters deciding between the two candidates who garnered the most votes in the first election .
All four of the primary candidates had previously expressed at least some degree of willingness to accept federal funds to expand Medicaid, although all but Edwards had called for using a section 1115 waiver to craft Medicaid expansion in a state-specific way. Edwards support for Medicaid expansion was unequivocal.
In addition, lawmakers in Louisiana passed House Concurrent Resolution 75 in June 2015, which helped pave the way for the expansion of Medicaid. HCR75 allowed hospitals to implement a fee that would generate the revenue needed to pay the states portion of the cost of expanding Medicaid . HCR75 gave Edwards until April 1, 2016 to propose a plan to expand Medicaid, but he wasted no time in issuing the Medicaid expansion executive order the day after taking office.
Who Can Get Medicaid In Louisiana
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
You May Like: How To Apply To Medicaid Online
American Disabilities Act Notice
In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.
How Many People Are On Medicaid
According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:
- 78,521,263 individuals were enrolled in Medicaid and CHIP
- 72,204,587 individuals were enrolled in Medicaid
- 6,695,834 individuals were enrolled in CHIP
Also Check: Medicaid Healthy Connections Phone Number
What Is Pregnancy Medicaid
Medicaid is a government-sponsored health insurance program for low-income families who have no medical insurance or inadequate insurance. All states offer Medicaid or a program similar to Medicaid to help pregnant women receive adequate prenatal and postpartum care. Medicaid also offers health insurance to seniors, children, and people with disabilities.
Louisiana Chip Fact Sheet
For more than two decades, the Childrens Health Insurance Program has provided health coverage to children in families with low to moderate incomes. Each state has the option to cover its CHIP population within its Medicaid program, design and structure a separate CHIP program, or establish a combination program using both options.
CHIP is currently funded through federal fiscal year 2027 by the HEALTHY KIDS and ACCESS Acts. The Acts also extended the maintenance of effort provision, which requires states to maintain eligibility standards that were in place in 2010 through FFY 2027. However, beginning in FFY 2020 MOE only applies to children in families with incomes at or below 300 percent of the federal poverty level .
Modified adjusted gross income eligibility levels for CHIP/Title XXI in Louisiana
|213 250% FPL||213 250% FPL|
Income Eligibility Levels as a Percentage of the Federal Poverty Level for Children and Pregnant Women by State, April 2018. Note: Eligibility levels do not include the mandatory 5% income disregard.
Coverage for Pregnant Women
Using CHIP funding, states can opt to provide coverage for pregnant women and/or services through the unborn child coverage option. Louisiana provides coverage up to 209% FPL through the CHIP unborn child option.
Premiums and Cost Sharing
Program type: Louisiana operates a combination CHIP program called LaCHIP.
Premiums and selected cost sharing in LaCHIP, 2019
Don’t Miss: Chiropractor That Accepts Medicaid Nj
Louisiana Medicaid Income Limit
The Louisiana Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.
To qualify, you must meet the Louisiana Medicaid Income limits listed below.
Here is the Federal Poverty Level for 2021.
|2021 Federal Poverty Levels for the 48 Contiguous States & D.C.|
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 212 percent of FPL
- Any child age 1-5 with a family income up to 212 percent of FPL
- Children ages 6- 18 with family income up to 212 percent of FPL
- CHIP for children with family income up to 250 percent of FPL
- Pregnant women with family income up to 133 percent of FPL
- Parents of minor children with family income up to 19 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 74% of the FPL
- Adults without dependents under Medicaid expansion with income up to 133% of the FPL
If You Or Your Loved Ones Have Been Impacted By Severe Weather
UnitedHealthcare is helping members who may be affected by severe weather and flooding. If you need help please call member services at , TTY 711.
A free emotional-support help line is also available to everyone at , TTY 711 and is open 24 hours a day, seven days a week. The service is free of charge and open to anyone. Trained Optum mental health specialists can help you manage stress and anxiety. Callers may also be referred to community resources to help with other concerns, including financial and legal matters.
You May Like: Dental Care That Accepts Medicaid
Louisiana Medicaid Income Limits Summary
We hope this post on Louisiana Medicaid Income Limits was helpful to you.
If you have any questions about Medicaid in the state of Louisiana, you can ask us in the comments section below.
Help us spread the word! If you found this post on Louisiana Medicaid Income Limits helpful, help us spread the word by sharing it using the Share this button below.
Be sure to check out our other articles about Medicaid.
Who Is Eligible For Medicaid In Louisiana
Depending on the reason for eligibility, low-income Louisiana residents can qualify for Medicaid based on income alone, or a combination of income and assets. Eligibility is based only on household income for children, people who are pregnant or postpartum , parents of minor children, and childless adults up to age 64 . But for the aged, blind, and disabled, eligibility rules are more stringent, with both income limits and asset limits.
Don’t Miss: How Do I Get A Free Medicaid Phone
Wellhop For Mom & Baby
Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.Heres how it works:
- Join video conversations every other week with women who have similar due dates and a group leader.
- Chat and share experiences with moms from your group on the Wellhop app or website.
- Visit the Wellhop library. Youll find articles, videos and more.
Thousands More People With Medicaid And Chip Coverage Now Eligible To Access Critical Postpartum Coverage Thanks To The American Rescue Plan
Louisiana is the first state to partner with the Biden-Harris Administration to extend Medicaid and CHIP postpartum coverage for a full 12 months under its state plan, and additional states are seeking to extend coverage under the American Rescue Plan
The Biden-Harris Administration is announcing that, beginning today, as many as 720,000 pregnant and postpartum people across the United States could be guaranteed Medicaid and Childrens Health Insurance Program coverage for a full 12 months after pregnancy thanks to the American Rescue Plan . Medicaid covers 42 percent of all births in the nation, and this new option for states to extend Medicaid and CHIP coverage marks the Biden-Harris Administrations latest effort to address the nations crisis in pregnancy-related deaths and maternal morbidity by opening the door to postpartum care for hundreds of thousands of people.
In addition to related updates in the 2023 federal budget request, for example, in December 2021, Vice President Kamala Harris hosted the first-ever federal Maternal Health Day of Action, where she announced a to both the public and private sectors to help improve health outcomes for parents and infants in the United States. Todays announcements are a part of the Biden-Harris Administrations continued response to that call to action to support safe pregnancies and childbirth, and reduce complications and mortality in the year following birth.