FAQ - Application and Enrollment

Application Status Checks

  1. What is the process to check status of an application we have previously submitted? 
    LDH has created a form that can be submitted. 

  2. Where can I find Medicaid expansion applications?
    It is the same application that is currently used for non-Expansion Medicaid. LDH's preference is electronic application or telephone applications as they allow for faster processing but paper applications (Application for Coverage, BHSF Form 1A Revision Date 7/24/15) will be accepted. The paper application can be downloaded from the LDH website by clicking on the link "Apply by Mail." 

Eligibility Inquiry Responses

  1. Will the July 1 eligibility date for clients rolling over from GNOCHC/Take Charge be reflected in the online Medicaid Eligibility Verification System prior to July 1?
    Yes, eligibility responses show up to twelve months historical eligibility and three months future eligibility. For example, on 6.20.16, the eligibility response will show Take Charge Plus eligibility only for date of service 6.1.16 and New Adult Group plus name of Health Plan for a future date of service 7.1.16. LDH strongly recommends that providers wait until 6.15.16 to start proactively checking July eligibility and Health Plan assignment.

  2.  College students who work on campus: is this considered income?
    We do expect a lot will be eligible, depending on if they are being claimed on someone's income taxes. If they are the parent/guardian claiming them, then income will be included.

  3. Are income limits gross or net?
    We look at gross income for expansion - no deductions.

  4. Will Pharmacy reimbursement still be the same?
    Yes - No change
    .
  5. For adults covered under expansion will they be covered for eye and dental?
    Dental visits that the five Health Plans provide are the adult dental that current folks get except 19 and 20 year olds. This will continue through MCNA. The five Plans do offer adults some extra dental/eye benefits. Those vary by Plan and you can see the dental/vision benefits under outreach material there is a comparison chart. There is no change in benefits that the Healthy Louisiana Plans are required to supply.

  6. When a Provider Request for Eligibility Status form is faced in, how will the person who requested the status be notified of the status?
    The form is completed with the requested information and faxed back to the provider. 

Enrollment Data for New Adults

  1. Will it be possible to get data on the number of people enrolled periodically moving forward? Will reports be available to judge our progress on a community level for the number of successful enrollments?
    LDH plans to provide weekly enrollment updates through the Healthy.la.gov website on the number of New Adults enrolled at the parish level.

Medicaid Application Centers

  1. How can I become a LDH-certified Medicaid Application Center?
    See the Resources section at Healthy.la.gov.

  2. Will Medicaid AC Representatives be able to look in a system to see if an application has been submitted for a particular person or is pending review? We are concerned with flooding the system with multiple applications for the same person and want to mitigate that.
    No -- Medicaid AC Representatives do not have inquiry rights to see pending application status or denials. Providers can determine through the Medicaid eligibility verification systems that an individual has been approved but cannot see pending applications or denied applications. Outstationed eligibility workers have real time access to all Medicaid eligibility systems and can see if an application is already pending and if it has been denied in the past 30 days. They also can see if the application can be reopened without completion of a full application, as well as if someone qualifies for SNAP-assisted enrollment and doesn't need to complete a full Medicaid application. 

  3. What should providers do if the healthcare.gov website goes down and is not functioning? Should they fill out the application through Medicaid.la.gov? Are health centers still eligible for payments in this situation? (During each Marketplace open enrollment the healthcare.gov website inevitably stops working at some point due to volume.
    Completing the LDH online application will continue to be an option and we will continue to pay $14 for completed applications.

  4. How can we get our Medicaid Application Center added to the list of locations where someone can apply In Person on the Healthy.la.gov website?
    Send an email to healthy@la.gov and request to be added. The listing of Application Centers, who have agreed to provide assistance with New Adult applications, is continually being updated and changes will be reflected on the website as quickly as possible.

  5. What is the status of training regarding Expansion/Healthy Louisiana for Medicaid Application Center representatives?
    Adult Group Training was released May 24, 2016 by email to current Application Center Representatives. The training slides have been posted to the Application Center Resource Library.

SNAP Assisted Enrollment

  1. Can we get a supply of the forms sent to persons getting SNAP who can enroll without completing a full application and who do not have the letter with them?
    The form -- including a place to indicate the names of all members of the SNAP household -- can be downloaded from the Resources section of the Healthy.la.gov website. The form includes information on ways to respond (telephone, fax, e-mail, regular mail).

Enrollment Events

  1. I would like to host an enrollment event and have someone from Medicaid assist with Medicaid application completion. What are our next steps?
    Application assistance at your event can be conducted by Medicaid staff or a certified Medicaid Application Center. To request Medicaid assistance, fill out the online form. Visit our website to find a Medicaid Application Center to assist you.

Online Application Using Healthcare.gov

  1. Has it been finalized that Medicaid Application Centers should enter their LDH Medicaid Application Center number preceded by zeros to get the 13-digit number when completing the application Medicaid through Healthcare.gov ?
    Yes, the LDH Medicaid Application Center number and leading zeros to equal 13 characters should be entered in the "ID number" field on the "Help applying for coverage" screen.