Louisiana Hhs Director Pushes To Keep Medicaid Expansion
On January 5, 2016, Edwards named Dr. Rebekah Gee to be the director of Louisianas Department of Health and Hospitals, which is the agency that oversees the states Medicaid program. Edwards said that Medicaid expansion would be one of Gees primary tasks, and Gee noted that the state would need to hire almost 250 people to process enrollments and manage the expansion of Medicaid.
Gee also said that Edwards administration would focus on working with doctors to ensure that there would be an adequate network of providers willing to work with the influx of new Medicaid patients gaining coverage under Healthy Louisiana.
Gee noted that in addition to the states portion of the cost of coverage for the newly eligible population, the state also had to pay 25% of the cost of hiring the 248 new state employees to handle the additional volume in the Medicaid program. The federal government would pay 75% of that cost, but the states portion was expected to be $2 million. Gee said that she was aware of the budget problems that were inheriting, calling them humbling but noting that the new administration had plans to deal with the budget issues.
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, pregnant women, 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.
Unitedhealthcare To Continue To Serve Louisianans Enrolled In Medicaid
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Medicaid beneficiaries in Louisiana will continue to have access to UnitedHealthcare medical and prescription drug plans, and preventive health and wellness programs
UnitedHealthcare to Continue to Serve Louisianans Enrolled in Medicaid
The Louisiana Department of Health selected UnitedHealthcare Community Plan to continue administering its Louisiana Medicaid program, effective Jan. 1, 2020.
UnitedHealthcare Community Plan of Louisiana is one of four managed care organizations awarded contracts to serve people enrolled in the Louisiana Medicaid program.
UnitedHealthcare Community Plan will continue to offer a health benefit plan for adults and children who may qualify for Louisiana Medicaid, including access to the plans care provider network and health and wellness programs. UnitedHealthcare Community Plan offers comprehensive health coverage including preventive care, primary care, hospitalization, prescriptions and other covered services.
We are honored to have provided Medicaid coverage to Louisianans for the past seven years and look forward to our continued partnership with the state to continue to serve people, said Scott Waulters, interim CEO, UnitedHealthcare Community Plan of Louisiana.
UnitedHealthcare Community Plan of Louisiana currently provides health care coverage to 420,000 Louisianans enrolled in Medicaid. Additionally, more than 510,000 Louisianans are enrolled in UnitedHealthcare employer, individual and Medicare plans.
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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.
Health Insurance Coverage For Multiple Years
TriTerm Medical Insurance,4 underwritten by Golden Rule Insurance Company, is short term health insurance that offers coverage for preventive care, doctor office visits, and prescriptions.
- Apply once for insurance coverage terms that equal one day less than 3 years.
- $2 million lifetime maximum benefit per covered person on most plans.
- Eligible expenses for preexisting conditions are covered after 12 months on the plan.
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Health ProtectorGuard fixed indemnity insurance,5 underwritten by Golden Rule Insurance Company, can supplement your major medical plan by paying cash for eligible, covered medical services, like a doctor visit, a trip to urgent care or a surgical procedure.
- No deductibles or copays to pay first
- Benefits paid regardless of other insurance
- Money to pay costs not covered by major medical plans, like a deductible
Healthy Louisiana Plan Eligibility
You must qualify for Medicaid to be a member of this health plan.
Medicaid is a program for people with low to moderate incomes who meet certain eligibility requirements.
To see if you qualify for Medicaid, call the Medicaid hotline toll free at 1.888.342.6207 or visit the Louisiana Medicaid website.
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Unitedhealthcare Senior Care Options Plan
UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.
Prior Authorization And Notification Resources
For BH Auth Inquiries: 866.675-1607
Your “one call” resource line. Contact for information regarding:
- Behavioral Health referral
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If your office relocates or closes for an extended period, please contact us at 1-877-369-1302.
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Are your patients prepared for hurricane season?
We want to help make sure your patients are prepared for hurricane season and the resulting hazards such as storm surge, high winds, tornadoes, and flooding.
View the Are You Storm Ready? preparation and tips flyer.
Tips from Louisiana Governor’s Office and the American Red Cross
- Update Contact Information: Encourage your patients to regularly update their address and phone contact information, so they can be reached in case of an emergency.
- Members can contact UnitedHealthcare Community Plan Member Services at 1-866-675-1607 or contact the NurseLine at 1-877-440-9409.
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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 enrollees no longer receive phone calls from Louisiana Medicaid when their coverage is up for renewal notices and requests for additional information will 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 .
What Is The Maximum Income For Medicaid In Louisiana
The income limits for Louisiana Medicaid vary depending on whether the applicant is a child, pregnant woman, parent of a minor child, childless non-elderly adult, or aged/blind/disabled. For the groups that qualify based on income alone, eligibility is determined as a percentage of the federal poverty level . As of 2021, Louisianas Medicaid eligibility standards are:
- Children ages 0-18: 212% of the federal poverty level
- Children with family income between 212% and 250% of FPL are eligible for the Louisiana Childrens Health Insurance Program
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Insurances Accepted At Ochsner
We understand that getting your insurance questions answered is important. We can share which insurance plans we work with, but not what is covered, co-pay information, or other details since those vary from plan to plan and change regularly. Only your insurance company can provide those details.
We accept most major insurances, but please contact your insurance company directly to confirm which procedures and providers are covered. The chart below contains a list of accepted insurances at each Ochsner facility.
Healthy Louisiana Plan How To Enroll
There are four ways to enroll in the Healthy Louisiana program:
Make sure to select UnitedHealthcare Community Plan.
Enrollment:You can change Health Plans for any reason during the first 90 days you are enrolled. After 90 days, if you are still eligible for Medicaid, you will be locked into the Plan for the nine months.
Open Enrollment:The state will send you a letter 60 days before the end of your enrollment year telling you that you can change Plans if you want to. This is called “open enrollment.” You do not have to change Health Plans. If you choose to change Plans during open enrollment, you will begin in the new Plan at the end of your current enrollment year. Whether you pick a new Plan or stay in the same Plan, you will be locked into that Plan for the next 12 months. Every year you can change Health Plans during your 60-day open enrollment period.
If you have questions about Open Enrollment, call Healthy Louisiana at , TTY: 1-855-LaMed4Me .
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Apply For Medicaid In Three Steps
1. Gather your information:
- Job informationyour employer and income amount.
- Policy numbers for any other health insurance you may have.
Dont worry. If you do not have answers to all the questions or all the information being requested, you can provide them later. Medicaid will notify you of next steps within 1-2 weeks after you submit your application.
2. Apply for Medicaid:
Helpful Tip: If you apply online, you have the option to create an account. This will let you:
- Save your application and finish it later
- Check the status of your application
- Renew your Medicaid online
- Request a new Medicaid card
3. Decide which health plan to join:
In the last step of the application, you will choose your health plan. There are five health plans. They all cover the same essential benefits, but each one has different networks of doctors, dentists, and other providers. There are also different extra benefits for adult dental services and reward programs. To compare plans, go to www.healthy.la.gov. We hope you choose us!
Louisiana Medicaid Provider Enrollment Disaster Relief
Department of Health & Human ServicesCenters for Medicare & Medicaid Services1301 Young Street
Ms. Jen Steele, State Medicaid DirectorDepartment of HealthBaton Rouge, LA 70821-9030
Dear Ms. Steele:
We have reviewed your request for relief to CMS existing regulations and requirements to provider enrollment. You indicated the need for temporary waivers to give you the needed flexibility to address the disaster caused by Tropical Storm Barry. Under section 1135 waiver authority, we are able to grant your request. The language below outlines what provisions CMS has waived:
Louisiana Medicaid Provider Enrollment Disaster Relief
Louisiana currently has the authority to rely upon screening that is performed by other SMAs and/or Medicare. Louisiana is not required to create a temporary provisional enrollment for providers who are enrolled with another SMA or Medicare.
With respect to providers not already enrolled with another SMA or Medicare, CMS will waive the following screening requirements so the state/territory may provisionally, temporarily, enroll the providers:
For those providers located out of state/territory and from which Louisiana Medicaid participants seek care, enrollment is not necessary if the following criteria are met:
Sincerely,
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Unitedhealthcare Connected For Mycare Ohio
UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.
Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .
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.
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Louisiana Has Accepted Federal Medicaid Expansion
- 1,745,824 Number of Louisianans covered by Medicaid/CHIP as of May 2021
- 726,037 Increase in the number of Louisianans covered by Medicaid/CHIP fall 2013 to May 2021
- 50% Reduction in the uninsured rate from 2010 to 2019
- 71% Increase in total Medicaid/CHIP enrollment in Louisiana since late 2013
Do You Have Medicaid And Medicare
If you’re eligible for both Medicaid and Medicare, check into UnitedHealthcare Dual Complete,® which is a Dual Special Needs Plan .
These plans are available in some states. D-SNP can help you get more benefits and features than you can with Original Medicare, at no extra cost.
Don’t have an account? Register now1
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