A Guide to Healthy Louisiana - Louisiana Medicaid

Healthy Louisiana is a Louisiana program that provides comprehensive healthcare services to state residents. It combines the affordability of federal and state healthcare programs like Medicaid and the Louisiana Children’s Health Insurance Program (LaCHIP) with the personalized services of private insurance to deliver quality healthcare services locally.

Residents of Louisiana who fall below a certain income bracket, use other state-provided services, or have disabilities qualify for Louisiana Medicaid. According to a publication by laillumintor.com, as of April 14, 2023, “42% of the state's population receive Medicaid benefits”.

If you don’t meet the income requirements to qualify for Healthy Louisiana or if you need to extend your coverage, purchasing additional insurance through a third-party insurance provider is a good option to fill any coverage gaps and ensure you have the care you need.

We will help you explore how extending your insurance with help from Insurdinary can optimize your coverage to include a more comprehensive range of benefits and services by way of private health insurance.

    What Is Healthy Louisiana?

    The Healthy Louisiana plan is a state- and federal-funded program that provides low-income Louisiana residents with comprehensive coverage from an affordable marketplace healthcare provider. Comprehensive healthcare coverage through Ambetter is available in 27 states, including Louisiana. The Healthy Louisiana Plan began in 2016, attracting 233,794 enrollees within its first month. Ambetter Health Insurance invites you to join this plan if you qualify so that you and your family can access care at every life stage.

    Many residents would struggle to afford coverage or obtain the health services they need without this and other Louisiana Medicaid programs. The plans available through this program make insurance coverage more accessible for everyone.

    Some other common questions people often ask about this plan include:

    • Is Healthy Louisiana free? If you are eligible, you may be able to get healthcare coverage for free through Healthy Louisiana. If you are above a certain income threshold, you may pay low, affordable premiums without sacrificing quality coverage compared to other plans.
    • How is Healthy Louisiana funded? The federal government funds Healthy Louisiana and other Medicaid programs. Louisiana’s state authorities, such as the Louisiana Department of Health, provide any other needed resources.
    • What is Ambetter? Ambetter Health offers marketplace insurance coverage at competitive rates. Ambetter works with state-funded programs like Medicaid to ensure all Americans benefit from accessible health services and diverse treatment options that suit their family’s individual needs.
    • What is Ambetter coverage? Ambetter provides health insurance plans to cover medical, dental, and other healthcare services.

    What Is a Healthy Louisiana Card?

    Louisiana Medicaid

    Like the average insurance card, a Healthy Louisiana card contains pertinent information about your identity, your chosen care plan, and Ambetter as your provider. When you go to a doctor’s appointment or otherwise seek medical assistance, you can present this card to the staff members. They will use this card to contact your insurer and learn more about your health coverage.

    Applying for Healthy Louisiana

    Applying for Healthy Louisiana can be done via three different application methods:

    • In-person
    • Mail-in
    • Phone
    • Online

    Applying online is straightforward, but in the unlikely event technological complications arise, you should visit your local office in person. Make sure you specify Ambetter as your provider when completing your application. Otherwise, the government programs involved will choose a provider for you.

    An in-person application involves finding your parish on the Department of Health’s website. Clicking your parish will bring up a list of local application centers nearby. Choose the most conveniently located center and call to secure your application appointment. Not all centers accept walk-ins, so calling ahead is very important.

    To mail your application, print out and complete all input fields on the paperwork. Then, create copies of all the necessary documents (i.e., social security card or valid identification). Mail these documents to the following address:

    Medicaid Application Office
    P.O. Box 91278
    Baton Rouge, LA 70821-9893

    You may also apply for Ambetter coverage by phone and fax. Fill out the above-linked documents. Then, call 1-888-342-6207. The representatives assisting you may request that you fax any needed documents to the following number: 1-877-523-2987. Have your identification and application documents ready for a speedy application process.

    Finally, you can quickly apply via the Louisiana Medicaid online portal. This method is often faster and more accessible for most people. You may use a computer or a handheld device.

    Eligibility Requirements

    How do you know whether you are eligible for a Healthy Louisiana plan through Ambetter? Although eligibility depends on the medical services you need, your eligibility generally depends on the following:

    • Social Security Income makes up part of your household income
    • You receive aid from the Office of Family Support
    • You have a disability identified by the Social Security Administration
    • Your vision is no better than 20/200 (legally blind), despite corrective lenses
    • Medicaid income limits apply to your household
    • You qualify as a low-income parent below age 19
    • You are currently pregnant
    • You have a breast or cervical cancer diagnosis with no coverage

    Getting a Healthy Louisiana Card

    Obtaining a Healthy Louisiana card begins with completing and submitting an application online, in person, or over the phone.

    Administrators will review your application once they receive it. A typical application is approved within approximately 45 days, whereas the approval process for applications based on disability may take around 90 days to complete. You will receive a letter from Healthy Louisiana confirming your choice of Ambetter as your provider, as well as a state-issued insurance card.

    Once Ambetter receives confirmation of your approval, you will also receive an Ambetter membership I.D. card. You can take this card and your government-issued card to all health-related appointments. These cards will have your name, your insurance number, and other information that doctors use to bill Ambetter for your care.

    Renewing or Replacing Your Louisiana Medicaid Card

    Before your Healthy Louisiana membership card expires, you’ll receive a renewal notice letter in the mail. The letter reminds you to renew your coverage and provides the following details:

    • Coverage expiration date
    • Coverage renewal methods, including online portals and phone numbers for assistance
    • How to communicate if you need a renewal extension

    You must renew your coverage even if you change nothing about your income or other eligibility requirements.

    What happens if your Healthy Louisiana card becomes damaged, lost, or misplaced? Simply call the helpline at 1-877-252-2447. When prompted, select the “Replace Medicaid Card” option from the menu. Then, input the requested information. You can also replace your card by logging into your online portal.

    Louisiana Medicaid - Healthy Louisiana Coverage

    Ambetter Health offers marketplace insurance plans with extensive coverage options. Therefore, you can access various benefits regardless of your financial limitations. Explore what you can access through your Healthy Louisiana plan.


    Dental services covered by Louisiana Medicaid protects your oral health in many ways. According to the ldh.la.gov website, effective January 1, 2021 “the Louisiana Department of Health (LDH) has contracted with DentaQuest and MCNA Dental to provide dental benefits for qualified Medicaid enrollees”. Included services are:

    • Early and periodic screening, diagnostic, and treatment services (EPSDT): This program assists children from birth to 20 years old in obtaining diagnoses, protective and restorative procedures, and certain surgeries.
    • Adult waiver dental services: These services offer similar benefits as EPDT for adults over the age of 21.
    • Adult denture services: Adults 21 and over can access denture fittings and related procedures within certain guidelines.

    It’s important to note that Louisiana Medicaid and its dental partners will only cover the above up to certain amounts. For those who anticipate requiring more visits to the dentists, investing in private dental plans in Louisiana is advisable.

    Prescription Drugs

    In addition to state-funded pharmacy services, you can access various prescription programs to ensure affordable access to necessary drugs your doctor prescribes. Some Louisiana programs include:

    • The SeniorRX Program: If you have a disability or are over age 60, you can qualify for this program to cover prescription drug costs.
    • Louisiana Drug Card: This website provides Louisiana residents with access to coupons and discount codes for prescriptions from major brands and generic medicines.
    • Louisiana STD/HIV/Hepatitis Program: If you need treatment for an STD, you can qualify for this program for assistance affording prescriptions.

    Extended Health Care

    Some types of Healthy Louisiana coverage from Ambetter covers various extended healthcare services like the following:

    • Vision: Keep the basics of optical health covered and controlled with exams, vision correction, cataract removal, and more.
    • Audiological: The state hearing aid program offers digital hearing aids.
    • Specialist services: Explore various specialist services to improve your health and well-being, including physical therapy, occupational therapy, podiatry, and much more.
    • Medical equipment: You or one of your household members might require equipment to facilitate mobility or ostomy supplies to manage diabetes. This service helps cover those expenses.
    • Disabilities: Louisiana Medicaid will not cover all costs related to temporary or permanent disabilities. You can purchase disability insurance to shield your household against sudden income loss due to health-related problems.

    Travel and Out-Of-State Coverage

    Can you use your Healthy Louisiana coverage through Ambetter while traveling to different countries or out of state? If you travel outside of the United States, you will not receive assistance from any Medicaid program, including Healthy Louisiana. For this reason, if you are traveling outside of the USA for leisure, invest in proper travelers insurance.

    However, you can use your Medicaid coverage in other states as long as your provider has in-network doctors in that state. By choosing Ambetter, you increase your national traveling options significantly since this provider operates nationwide.

    Students and Seniors

    Does the Healthy Louisiana plan cover college students? The answer depends on your situation and chosen living arrangements. If you are planning to attend an in-state college, you might qualify for the plan if:

    • You are not a dependent.
    • You are not covered by a school plan or another type of applicable insurance plan.
    • You are legally an adult of 20 years or older.
    • You meet all other outlined requirements.

    Speak with an Ambetter agent about your student situation. Since Ambetter operates within 27 states, you might qualify for assistance regardless of your location.

    How does the plan assist senior adults? If you are over the age of 60 or have other qualifying conditions, you can access the following advantages:

    • Home health assistance: You can access physical and occupational therapeutic sessions, nursing assistance, and aid from the comfort of your home.
    • Hospice: This service provides individuals in need of specialized care at home with the resources to make adjustments to facilitate that care.
    • Long-term care or nursing facilities: If you can no longer live safely at your residence, you can find long-term care and rehabilitation at state facilities.

    These resources make your senior years much easier and give you peace of mind that you have access to care as your needs change.

    Coverage for Subgroups

    If you fall within a certain demographic, you may be eligible for healthcare service extensions. Ambetter proudly supports the veterans, military members, and American Indians through Healthy Louisiana.

    American Indians

    Does your household include a child with a verifiable membership to a Native American or Alaskan tribe? If so, LaCHIP exempts your household from monthly premiums, which saves you at least $50 a month. You may need to provide tribal membership verification in addition to other I.D. documents during the application process.


    Despite offering various resources, governmental programs can sometimes leave gaps in coverage for veterans or active military members when they need help the most. If you are a veteran or on active duty, you can access numerous resources through your coverage. These services include:

    • Addiction assistance
    • Behavioral health care
    • Counseling and therapy
    • Some healthcare provisions

    What Healthy Louisiana Does Not Cover

    Although your Healthy Louisiana coverage through Ambetter offers comprehensive services, some limitations do apply. Your plan does not cover the following supplies and services:

    Provider-preventable conditions: In the event a care provider makes a mistake during treatment, you must seek compensation from the responsible establishment.
    Equipment and services deemed medically unnecessary: If you don’t meet the prerequisites for a certain service or treatment, you may not receive coverage.
    Organ harvesting from Medicaid cardholder: If you choose to donate an organ, you must pay for the procedure out of pocket or through supplemental health insurance coverage.
    Experimental treatments: Treatments and services that haven’t gone through testing on humans often fall into this category.
    Incomplete surgical procedures: If billable preparations or preliminary services for a treatment began without full follow-through, your plan may not cover them.
    Cosmetic treatments: Treatments such as reconstructive procedures or plastic surgeries are often medically unnecessary.
    Fertility treatments: Although infertility represents a personal struggle, treatments to help you or your partner conceive are not typically covered.

    If you wish to pursue these medical services, you must seek alternative ways to fund them, such as by purchasing additional coverage through a third-party insurance provider.

    It is also important to note that Louisiana Medicaid does not cover the cost of funerals. While the state offers basic resources and very limited monetary benefits towards burial costs, what is available will most definitely not cover burial costs and services. It is always wise to ensure that in the event of your passing, your family is secured with comprehensive funeral insurance.

    If you are looking for even more insurance coverage beyond what Louisiana Medicaid provides, such as life insurance, consider exploring your options. Visit our life insurance quote page to get personalized quotes and find a policy that suits your needs.

    Common Procedures and Healthy Louisiana Eligibility

    You might be confused about what Ambetter and other Louisiana Medicaid programs cover. Although eligible treatments, procedures, and medications may change from time to time, you and your primary care provider should focus on one specific aspect to determine if insurance will cover it: Is the treatment medically necessary to prolong and improve your overall health?

    Medical necessity is the main differentiator as to whether your plan will cover your treatment. Fortunately, you can speak with an Ambetter, or related, representative to verify and confirm your needs. However, certain restrictions may apply depending on what the state deems a medical necessity under a particular circumstance.

    Dispel some of the confusion by exploring the common health services listed below. If you want access to additional services, you may explore ways to extend your coverage.

    X-Rays Yes
    Exams Yes
    Orthodontic services Yes
    Maxillofacial prosthetics for congenital abnormalities Yes
    Dentures Yes
    Disease and injury treatment Yes
    Endodontic services Yes
    Restorative services Yes
    Preventative services Yes
    Diagnoses Yes
    Examinations Yes
    Diagnosis and treatment of various eye conditions, such as cataracts and infections Yes
    Childhood vision correction Yes
    Authorized eyewear and contacts Yes
    Refraction error treatment Yes
    Maxillofacial surgery Yes
    Outpatient surgeries Yes
    Medically necessary surgeries Yes
    Emergency surgeries Yes
    Emergency room services with no limits Yes
    Inpatient hospital visits Yes, for illness or injury treatments and procedures requiring an inpatient stay
    Outpatient hospital visits Yes, for diagnosis, outpatient surgeries, and rehabilitation
    Therapy and Counselling
    Healthy Louisiana covers some mental health services, including: psychiatric hospital stays, community psychiatric support and treatment, residential treatment programs, addiction services, behavioral health services, individual, family and group counseling, personal care services and family training.
    Sexual Health
    Contraceptive education Yes
    Voluntary sterilization Yes
    Diagnosis and treatment of sexually transmitted infections Yes
    Screenings for and treatment of cervical cancer Yes
    Birth Control Yes, access and prescriptions to various birth control methods, such as contraceptive pills or IUDs
    HPV vaccines Yes
    Family planning services Yes
    Treatment and management of sexual and birth-related complications Yes
    Specialist Services
    Chemotherapy Yes
    Radiology Yes
    Audiological Yes
    Physical therapy Yes
    Occupational therapy Yes
    Speech and language therapy Yes
    Psychological therapy Yes
    Podiatry Yes
    Applied behavior analyst therapy Yes

    While these lists cover many of the benefits you can access through your Healthy Louisiana plan, please note that coverage amounts may change and certain services may be added or removed before this publication has been updated. Learn more about what your plan offers.

    Your diligence will help you make the right choice for you and your family. If you notice your plan doesn’t cover something you need, you can request further coverage recommendations from an Ambetter agent or pursue affordable extended insurance coverage through a third-party provider.

    Extending Louisiana Medicaid Coverage

    In some cases, state healthcare coverage through Ambetter won’t meet all of your medical or mental healthcare needs. Extending your Healthy Louisiana coverage with a supplemental plan from a third-party insurer ensures that you have comprehensive care that fills any coverage gaps.

    Third-party or private health insurance providers help their policyholders avoid certain limitations of government-provided health benefits. However, many Louisianans who rely on Healthy Louisiana don’t seek supplemental options.

    Benefits of private health insurance include:

    • Coverage in other states: While Healthy Louisiana may cover medical costs in other states, it often requires that enrollees complete complicated paperwork. Additionally, some enrollees need treatment in a different state. Private insurance providers make out-of-state coverage much easier to obtain.
    • Coverage caps: Medicaid only covers a certain portion of your medical expenses. This means you can only attend a predetermined number of doctor appointments within a month. Purchasing supplemental insurance from a private provider may remove those caps.
    • Delayed reimbursement: Most government programs can take months to reimburse you for medical services. A third-party insurer will quickly reimburse you.
    • Network limits: Some doctors, particularly specialists, don’t work within your Medicaid network. The closest and most accessible doctor who specializes in the procedure you need or want may require private insurance. Supplemental policies can open up your care opportunities.
    • Uncovered but necessary treatments: Healthy Louisiana identifies numerous treatments as medically unnecessary despite the positive impact these procedures can have on your life. If you need a “medically unnecessary” treatment, you can access it through your private insurance provider.

    While Medicaid is restrictive, it is also necessary for many people to receive basic healthcare. Once you’ve enrolled in Healthy Louisiana coverage, you can choose a private insurance company as your supplemental provider.

    Additionally, you can find out whether you qualify for extended coverage options. If you require additional coverage for certain treatments or procedures that Healthy Louisiana deems unnecessary or otherwise does not cover, let us at Insurdinary help.

    You can compare affordable insurance plans from top providers in Louisiana and choose the right supplemental coverage for you without interrupting your Ambetter plan. Our providers work great for families who operate within a budget, and with lower co-pays, flexible coverage options, and a variety of plans to choose from, you can find the coverage your family needs.

    At Insurdinary, we are committed to helping Louisiana residents find and compare healthcare plans. To compare Ambetter and other state healthcare plans or explore third-party insurance options, compare quotes with Insurdinary today.


    How long does it take to get approved for Louisiana Medicaid?

    The approval timeline for Louisiana Medicaid can vary, depending on factors like the completeness of your application and eligibility verification. Typically, it takes around 45 to 90 days to process an application. However, urgent situations can expedite the approval process.

    What are the methods to apply for Louisiana Medicaid?

    You can apply for Louisiana Medicaid through various avenues, including online applications through the Louisiana Health Insurance Marketplace, by phone, by mail, or in person at your local Department of Health office. The online application is often the fastest and most convenient way to apply.

    Does Louisiana Medicaid cover the expenses of funerals?

    No, Louisiana Medicaid does not cover funeral expenses. Its primary purpose is to provide healthcare coverage to eligible individuals and families, including services such as doctor visits, hospital stays, and prescription medications.

    Who is eligible for Louisiana Medicaid?

    Eligibility for Louisiana Medicaid is determined by income, family size, and other criteria. Eligible individuals usually include low-income families, children, pregnant women, individuals with disabilities, and seniors. Eligibility requirements may change, so it's advisable to check with the Louisiana Department of Health for the most current information.

    What is Louisiana Medicaid?

    Louisiana Medicaid is a program funded by the state and federal government that offers healthcare coverage to eligible low-income individuals and families. Its primary goal is to ensure that vulnerable populations have access to essential medical services, promoting and improving their overall health.

    What other types of insurance does Insurdinary offer?

    Insurdinary, and its network of partners offer many different types of insurance. In addition to health, dental, disability, life, funeral and travel insurance as discussed on this page, you may also be interested to explore the following:


    1. https://files.kff.org/attachment/fact-sheet-Becoming-Healthy-Louisiana-System-Assisted-Medicaid-Enrollment
    2. https://ldh.la.gov/page/262
    3. https://ldh.la.gov/assets/medicaid/MedicaidEligibilityForms/MedicaidApplicationPub.pdf
    4. https://ldh.la.gov/page/319
    5. https://ldh.la.gov/page/1371
    6. https://sspweb.lameds.ldh.la.gov/selfservice/
    7. https://www.medicaid.gov/chip/eligibility-standards/waiting-periods-chip/index.html
    8. https://ldh.la.gov/assets/medicaid/Memos/HowToRenew.pdf
    9. https://ldh.la.gov/page/324
    10. https://ldh.la.gov/page/358
    11. https://www.louisianaanswers.com/index.php?option=com_content&view=article&id=88&Itemid=487
    12. https://louisianadrugcard.com/
    13. https://ldh.la.gov/page/919
    14. https://ldh.la.gov/page/330
    15. https://ldh.la.gov/page/337
    16. https://ldh.la.gov/page/HearingAid
    17. https://ldh.la.gov/page/331
    18. https://ldh.la.gov/page/4256
    19. https://healthcareinsider.com/lousiana-student-health-insurance-26901
    20. https://ldh.la.gov/page/344
    21. https://ldh.la.gov/page/345
    22. https://ldh.la.gov/page/2446
    23. https://ldh.la.gov/index.cfm/faq/category/19
    24. https://ldh.la.gov/page/2591
    25. https://ldh.la.gov/assets/docs/Making_Medicaid_Better/Medicaid_Services_Chart.pdf
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