Louisiana Medicaid

Medicaid serves as Louisiana’s health care coverage program for residents that fall in the low-income category, and who also meet certain eligibility requirements.

Medicaid is the largest and most availed type of cheap health insurance plans. This is affordable primarily because it is subsidized by the government. Most companies are also enrolled in group health insurances by Medicaid and employers have a share in paying these premiums. On the other hand, employees’ salaries are automatically deducted the amount that go into their health care fund. Louisiana Medicaid is also among the few health insurance coverage plans which can offer as many as three beneficiaries. However, it is limited only to second degree of consanguinity, whereas private insurance companies can offer claims up to second degree of consanguinity.

Medicaid Benefits

Medicaid supports over 60 million Americans in their healthcare needs from medications, hospital rooms, doctor’s fee, surgeries, therapies, and other services which are eligible to their plan. This insurance plan caters all types of beneficiaries like children, pregnant women, senior citizens, and persons with disabilities. In order to become eligible for Medicaid, you have to comply with certain federal and state requirements. Because it is the responsibility of every state government to provide people with healthcare services, they legislate and implement their own regulations based on the overall status of the healthcare industry. Of course, Medicaid is a national program which has its own general rules for every state to follow.

Beneficiaries can choose from mandatory to optional benefits offered by Medicaid. For premium claims, pregnant women can get as much as $22,000 for a family of two members; disabled and working individuals have $16,000. Disabled individuals who are under the TWWIIA of 1999 are also covered by Medicaid as well as disabled children under the Family Opportunity Act. On the other hand, Medicaid insurance holders are entitled to up to 20% of the total cost of prescription drugs with the state’s jurisdiction whether the drug is preferred on not preferred.

Medicaid can also cover the use of the emergency department upon the hospital’s assessment of the following conditions:

  • The patient is really in need of emergency services
  • Alternative non-emergency units are available but Medicaid is of lesser payment
  • The hospital made the specific referral and identified copayment before the service has been rendered.

The Department of Health and Hospital in the state of Louisiana lists the following services and facilities as supported by Medicaid.

  • Audiological
  • Chemotherapy
  • Chiropractic
  • Dental
  • Durable Medicaid Equipment (ie. Wheelchairs, leg braces, etc)
  • Expanded Dental Services for Pregnant Women (EDSPW)
  • Eyeglass Services
  • Family Planning Clinic Services (i.e. Contraception)
  • Hearing Aids
  • Hemodialysis Services
  • Home Health
  • Hospice
  • Hospital – Emergency Room Services, Inpatient Services, Outpatient Services
  • Immunizations (Shots)
  • Laboratory Tests & Radiology Services
  • Long Term – Personal Care Services (LT-PCS)
  • Mental Health
  • Midwife Services (Certified Nurse Midwife)
  • Multi Systemic Therapy
  • Occupational Therapy Services
  • Optical Services
  • Orthodontic Services
  • Pediatric Day Health Care (PDHC)
  • Pharmacy Services (Prescription drugs)
  • Physical Therapy
  • Physician/Professional Services
  • Podiatry Services (Feet)
  • Pre-natal care
  • Psychiatric Hospital Care
  • Psychiatric Evaluation and Therapy Services
  • Rehabilitation Clinic Services
  • STD Clinics
  • Speech Therapy and Language Evaluation and Therapy
  • Substance Abuse Clinic Services
  • Support Coordination
  • HIV
  • Therapy Services
  • Tuberculosis Clinics
  • X-Ray Services