Louisiana Application for Presumptive Eligibility for Medicaid

State:
Multi-State
Control #:
US-0538BG
Format:
PDF
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Description

Use this form to find out quickly if you qualify for presumptive eligibility for Medicaid. Presumptive eligibility offers you and your family immediate access to health care while you apply for regular Medicaid or other health coverage.
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How to fill out Application For Presumptive Eligibility For Medicaid?

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FAQ

We will make a decision 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 can start as early as 3 months before the month you apply.

Medicaid is also required to check with your financial institutions electronically to be sure we know about all assets and resources.

If you are not sure if you have Medicaid health coverage, call Medicaid Customer Service toll free at 1-888-342-6207. You can apply for Medicaid at any time.

The most common thing Medicaid will ask for is proof of income, like check stubs from a job. If you have access to the Internet on a computer, mobile device or smartphone, you can scan documents or take pictures of documents and submit them online in the Louisiana Medicaid Self-Service Portal (SSP).

The most common thing Medicaid will ask for is proof of income, like check stubs from a job. If you have access to the Internet on a computer, mobile device or smartphone, you can scan documents or take pictures of documents and submit them online in the Louisiana Medicaid Self-Service Portal (SSP).

You may qualify for Medicaid if you are: Are age 19-64 and make less than 138% of the Federal Poverty Level (about $16,000 for a single person living alone, or about $33,000 for a family of four.

ProgramFamily Size/Monthly Income LimitsLaCHIP - for children$2,637$9,143LaCHIP Affordable Plan - for children$3,099$10,744LaMOMS - for pregnant women$5,815Medicaid Purchase Plan - for workers with disabilities$1,2156 more rows

Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580. Per CMS guidance, there is no deadline for states to implement the Medicaid expansion.

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Louisiana Application for Presumptive Eligibility for Medicaid