You can now apply or renew your Medicaid online with our easy-to-use online application. To access the online application, click here.

Anyone applying for or renewing Medicaid services for any Medicaid program can use the online application. You can use this application if you want to apply or renew:

• Medicaid
• LaCHIP
• LaCHIP Affordable Plan
• LaMOMS
• Medicaid Purchase Plan
• Medicare Savings Program
• TAKE CHARGE
• Family Opportunity Act
• Breast and Cervical Cancer Program

Once you submit your online application, it is sent immediately to the office that will process your application. There is no delay for mailing or faxing a paper form.

If you prefer to fill out a paper application form, you can download and print an application and then mail or fax it to us.

If you want to download the paper application for the program you are applying for, just click on the program below.

• Medicaid, Renewal Form (General application for Medicaid programs below except Long Term Care)
• LaCHIP and LaCHIP Affordable Plan, Renewal Form
• LaMOMS
• Medicaid Purchase Plan, Renewal Form
• Medicare Savings Program
• TAKE CHARGE, Renewal Form
• Family Opportunity Act
• Breast and Cervical Cancer, Renewal Form
• Long Term Care, For SSI Recipients, Renewal Form