Louisiana Medicaid covers a broad range of health services, from hospital stays and doctor visits to prescription drugs, mental health care, and long-term support. The program serves over a million residents, including low-income adults, children, pregnant women, seniors, and people with disabilities. Here’s a detailed look at what’s included.
Who Qualifies for Louisiana Medicaid
Louisiana expanded Medicaid in 2016, opening coverage to adults aged 19 through 64 who don’t have Medicare. For a single person, the income limit is roughly $1,836 per month. For a family of four, it’s about $3,795 per month. These figures are based on federal poverty level guidelines and adjust slightly each year.
Children have their own pathway through LaCHIP, Louisiana’s Children’s Health Insurance Program. To qualify, a child must be under 19 and not currently covered by other health insurance, and household income must fall below the program’s limits. Pregnant women, seniors, and individuals with disabilities each have separate eligibility categories with their own income thresholds.
Hospital Care and Emergency Services
All Medicaid beneficiaries in Louisiana are covered for inpatient hospital stays when treatment can only be provided safely in a hospital setting. This includes the basic services a hospital is expected to deliver during an admission, such as nursing care, medications given during your stay, and standard room charges.
Outpatient hospital services are also covered, including outpatient surgery, chemotherapy, dialysis, and diagnostic imaging like X-rays and MRIs. If you need outpatient rehabilitation, such as physical therapy, occupational therapy, or speech therapy, those are covered too, though they require prior authorization from your health plan before treatment begins.
Emergency room visits have no service limits. If you experience a medical emergency, you’re covered regardless of the type of condition or how many times you need emergency care.
Doctor Visits, Lab Work, and Prescriptions
Routine visits to a primary care doctor, nurse practitioner, nurse midwife, physician assistant, or clinical nurse specialist are all covered. This includes office-based family planning services. Most diagnostic lab tests and radiology services ordered by your doctor are covered as well, so blood work, imaging, and other testing generally won’t come with a bill.
Prescription medications are a core benefit. Louisiana Medicaid pays for drugs prescribed by your provider, though your managed care plan maintains a list of preferred medications. If your doctor prescribes something not on that list, they can request an exception.
Mental Health and Substance Use Treatment
Behavioral health services are fully integrated into Louisiana’s Medicaid managed care plans, known as Healthy Louisiana. Coverage spans both mental health and substance use disorders, including outpatient counseling, mental health rehabilitation, psychological testing, and therapy. Inpatient psychiatric care is available when needed, and the state also runs acute behavioral health units and community-based clinics.
For opioid use disorder specifically, Louisiana has dedicated resources connecting residents to local recovery support, medication-assisted treatment, and information on safe drug disposal. The state’s 988 helpline provides immediate support for anyone experiencing mental health distress, suicidal thoughts, anxiety, depression, or a substance use crisis.
What Children Get Through LaCHIP
Children under 21 on Louisiana Medicaid are entitled to all medically necessary health care, diagnostic services, and treatment that the program can cover. This is a broader standard than what adults receive, rooted in a federal requirement called Early and Periodic Screening, Diagnostic, and Treatment services.
The specific benefits for children include:
- Primary and preventive care: doctor visits, immunizations, and well-child checkups
- Hospital care: both inpatient and emergency visits
- Dental, vision, and hearing care
- Therapies: speech and language therapy, physical therapy, and occupational therapy
- Mental health services: clinic visits, psychological testing, and therapy
- Other essentials: lab work, prescription medicines, medical equipment and supplies, and help scheduling appointments
Dental and vision coverage for children is notably more generous than for adults. Kids receive comprehensive dental care and routine eye exams as a standard part of their benefits.
Pregnancy and Postpartum Coverage
Pregnant women qualify for Medicaid in Louisiana even if they wouldn’t otherwise meet income requirements. Coverage includes prenatal visits, labor and delivery, and all medically necessary care during pregnancy.
Since April 2022, Louisiana has extended postpartum coverage from 60 days to a full 12 months after pregnancy ends. This applies regardless of how the pregnancy ends, whether through delivery, miscarriage, or stillbirth. You remain continuously eligible through the last day of the month in which your 12-month postpartum period concludes, with no gaps or re-enrollment required during that time.
Non-citizens who are pregnant and enrolled in Medicaid receive emergency services coverage. During the extended postpartum period, their benefits are limited to treatment for emergency medical conditions.
Long-Term Care and Home-Based Services
Louisiana Medicaid pays for long-term care in nursing homes and group homes for people with developmental disabilities. But the state also offers several waiver programs designed to help people stay in their communities rather than move into a facility.
The main waiver programs are:
- Adult Day Health Care Waiver: for adults 65 and older and people with physical disabilities aged 22 to 64 who need a nursing facility level of care
- Community Choices Waiver: similar population, serving people 65 and older and those with physical disabilities aged 21 to 64
- New Opportunities Waiver (NOW): for individuals aged 3 and older with autism, intellectual disabilities, or developmental disabilities
- Residential Options Waiver (ROW): for people of any age with autism, intellectual disabilities, or developmental disabilities
- Supports Waiver: for adults 18 and older with autism, intellectual disabilities, or developmental disabilities
Each waiver requires that the person meet the level of care typically provided in an institutional setting. These programs often have waiting lists, so applying early is important if you or a family member may need home and community-based support.
Medical Equipment and Supplies
Louisiana Medicaid covers durable medical equipment when it’s medically necessary. This includes wheelchairs and other mobility devices, oxygen concentrators and respiratory supplies, CPAP machines for sleep apnea, and diabetic supplies like glucose monitors, insulin pumps, and continuous glucose monitoring devices. Your doctor needs to order the equipment, and some items require prior authorization before Medicaid will pay.
Non-Emergency Medical Transportation
If you need a ride to a doctor’s appointment or other covered medical service but don’t have transportation, Medicaid provides non-emergency medical transportation at no cost. The service is available to anyone enrolled in Medicaid, whether you walk, use a wheelchair, or have other mobility needs.
To use it, call your Healthy Louisiana health plan and request a ride at least 48 hours in advance (weekends don’t count toward that window). If you’re not enrolled in a managed care plan and receive fee-for-service Medicaid, you call the state’s transportation provider, Verida, at 1-855-325-7626 with the same 48-hour notice requirement. Plan ahead, because last-minute requests won’t be accommodated.