Written by a parent, not a doctor. Nothing here is medical advice.

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Louisiana program

Free health insurance for your child (Louisiana Medicaid)

Louisiana Medicaid provides free health coverage for eligible children under 19. A worker can check how it fits alongside existing insurance.

What it is

Louisiana Medicaid provides free health coverage for eligible children under 19. A worker can check how it fits alongside existing insurance.

Louisiana checks your child’s age, current income, household and existing insurance. The income comparison is a starting point. A Medicaid worker can identify the right coverage category before you make insurance changes.

Eligibility rules
  • Your child must be under 19 and live in Louisiana.
  • Current monthly income is the test. Annual income divided by 12 is only an estimate.
  • Louisiana decides your child’s Medicaid household using tax-filing and family-relationship rules. Some children use nonfiler rules instead. That household may differ from everyone at your address or on a tax return.
  • The children’s chart effective March 1, 2026 lists monthly limits of $2,651 for two people, $3,347 for three, $4,043 for four, $4,739 for five and $5,435 for six. These include the five-percentage-point allowance. The worker confirms the current table and the category that applies to your child.
  • If your child is 6 to 18 and already has insurance, the free line is lower: about $2,970 a month for four people. Without insurance it is $4,043.
  • The income figures above took effect March 1, 2026. A later income-table update can change the screening amount.
How it can help alongside work insurance
  • The hospital financial counselor can check both plans against your child’s doctors, pharmacy and treatment.
  • A Medicaid card does not make every bill payable. The service and billing rules still matter.
What needs checking
  • The private plan is billed first. The counselor can check the Medicaid billing rule before you accept a balance as yours.
  • Two plans can preserve access to your existing team, but the private premium and treatment approvals still need a review.
What you get
  • No premium and no child copays for covered hospital care, chemotherapy and prescriptions.
  • Help with rides to covered appointments.
  • Nursing and personal care at home when your child meets the separate care rules.
  • Earlier eligible bills may be covered. The look-back period depends on the application date.
What the help covers
  • A private insurer’s deductible, copay or coinsurance entry is not automatically an amount the Medicaid-enrolled provider may collect from you. Your financial counselor can check whether the service was covered and authorized and how both plans processed it. The Medicaid worker also needs to confirm which children’s category can cover your child while the private plan stays in place.
  • For children under 21, Medicaid’s EPSDT benefit reaches medically necessary services within Medicaid benefit categories. It does not guarantee every requested service.
If you decide to apply
  1. Ask the hospital financial counselor to help with the Medicaid Self-Service Portal or the phone application.
  2. Have your child’s identification, your Louisiana address, current income information and insurance cards ready.
  3. Include earlier hospital bills and the months they cover.

Louisiana Department of Health, Medicaid eligibility: 1-888-342-6207 · Official page ↗

After you apply
  • The usual federal decision limit is 45 days, or 90 days when disability must be decided. Limited documented exceptions apply. These are maximum processing periods, not mandatory waiting periods.
  • Through 2026, earlier coverage can reach three eligible months before the application month. For child applications from January 1, 2027, the federal period becomes two months.
  • Children under 19 generally receive 12 months of continuous eligibility. Spend-down enrollment is an exception.
  • Ask the financial counselor whether this hospital can assess your child for temporary presumptive coverage. A participating qualified hospital can start it on the assessment date. Without a full application, it generally ends on the last day of the following month. With a timely full application, it continues until the full decision.
Good to know

Having work insurance is a reason to discuss using both plans. The counselor can check your cancer team and billing arrangements.

Other details
  • Your private insurance is billed first when both plans cover your child. Your hospital can review an unexpected balance against Medicaid’s billing rules.
  • The exact hospital, oncology group and pharmacy must work with the Medicaid coverage you choose. LaHIPP offers a separate review of private-plan premiums.
  • For a Medicaid health-plan denial, the usual appeal window is 60 calendar days. Decisions normally take 30 days, or 72 hours when urgent; a permitted extension can add up to 14 days. A state hearing normally has a 120-day request window after the plan appeal decision. Your notice and the Medicaid appeals card explain the route.
  • If the plan cuts a service your child already gets, ask within 10 days of the letter for it to continue during the appeal. If you lose, the plan can ask you to repay that continued care.

Federal background: Medicaid and using Medicaid alongside private insurance.

Official sources
Ask your social worker

“Could Louisiana Medicaid help with my child’s treatment costs? What are the benefits and drawbacks of adding it, and could you help us apply if it makes sense?”

Why I’m asking: I want to understand what treatment would be covered and what using two insurance plans would mean.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File on the state portal, report this month's income and any insurance, and name the months that already have bills.

Your social worker

The oncology social worker or the hospital financial counsellor helps you file and follows the decision.

The care team

Nothing for ordinary children's Medicaid. Medical records are only needed for the Act 421 disability route.

Who decides
Louisiana Medicaid decides the income question; the health plan you choose runs the coverage.
Ask your social worker
“Can you help me file the Louisiana Medicaid application today, list the bills from the three months before, and check that the hospital and the oncology group are in the plan I pick?”

How to apply

First step: Apply at the Medicaid Self-Service Portal (sspweb.lameds.ldh.la.gov) or call 1-888-342-6207 this week, and ask the hospital's financial counsellor to sit with you while you do it.

  1. Apply on the state portal this week, or call 1-888-342-6207.
  2. List the months that already have bills so the three-month look-back covers the admission.
  3. Pick a Medicaid health plan the hospital and the oncology group both take.

Official application / program page ↗

Where it starts: Apply on the Medicaid Self-Service Portal or call 1-888-342-6207. Ask the hospital's financial counsellor to help you file the day your child is admitted.

What to gather

  • Your child's birth certificate or identification and Social Security number
  • Your Louisiana address
  • This month's income for each adult in the tax household
  • Insurance cards, if any
  • Hospital bills from the three months before you apply

How long: The state manual allows 45 days, or 90 days when a disability decision is needed. Once approved, coverage reaches back up to three months before the month you applied, and then runs twelve months.

What a yes looks like

A notice with coverage dates and a choice of Medicaid health plan. Check the hospital and the oncology group are in that plan before you choose.

What a no looks like, and the next move

Read whether the answer was about income, a document or a category. If it was income, ask in the same application about LaCHIP and about Act 421, which leaves parents' income out, and appeal by the date on the notice.

Watch out

  • Louisiana counts the tax household and this month's income, not last year's return and not everyone under the roof.
  • Your child can keep private insurance and have Medicaid too. Do not cancel the work plan to apply.
  • The same chart has a second children's line for uninsured children aged 6 to 19 above $2,970 a month for four. Ask the worker which category your child was put in.

Dates that change this

2027-01-01: Coverage reaches back up to three months now. For applications made on or after January 1, 2027 federal law shortens that to two months for children. Louisiana has separately proposed the same change from October 1, 2026, but that is a proposal, not a rule.

2027-01-01: Healthy Blue stops being a Louisiana Medicaid health plan on December 31, 2026 and is not available from January 1, 2027. If you are offered it, ask which plan you will be moved to and whether your oncology team is in it.

2026-03-01: The state chart carries a separate uninsured-only children's line for ages 6 to 19 above 108% of poverty. Which category an insured child in that band is placed in was not published; ask the worker. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full Louisiana Medicaid with no premium and no child copays. The line is $4,043 a month for four, $3,347 for three and $2,651 for two, allowance included.

  • $4,043/month — Household of 4, published children's line (147% of poverty, allowance included)
  • $3,347/month — Household of 3, published children's line
  • $2,651/month — Household of 2, published children's line
  • $4,739/month — Household of 5, published children's line
  • $5,435/month — Household of 6, published children's line
  • $2,970/month — Household of 4, the separate uninsured-only children's line for ages 6 to 19 (lower boundary, 108%)

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Anything medically necessary for a child under 21 that Medicaid can cover · Extended skilled nursing and personal care at home, once approved · Rides to appointments, and meals and lodging on long trips

Legal protection: Twelve months of continuous coverage for a child under 19, even if income rises

What it costs the family: No premium and no copays for a child.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
Children (Type case 14): at or below 147% FPIG, which the chart states as 142% plus a 5% disregard
Insurance status condition
The state FAQ says general Medicaid is open to insured children within the income rules; that page is search-index text only, so the site tells the parent to ask rather than promising it
Residency
Louisiana
Continuous eligibility
12 months for children under 19, with manual exceptions including spend-down
Retroactive months
3 now; 2 for applications made on or after 2027-01-01 (federal)
Processing standard
45 days, or 90 days when a disability determination is needed (Medicaid Eligibility Manual G-400)
Statute refs
LDH Medicaid Eligibility Manual Z-200 and G-0000; H-1900 for continuous eligibility

The trap: The same state chart has a second children's line for an uninsured child aged 6 to 19 whose income is above 108% of poverty, $2,970 a month for four. Which of the two categories an insured child in that band is put in was not published, so ask the worker which one they used. Do not drop private insurance to apply.

Where I read this

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