Updated 7/8/16
Medicaid Expansion & LA HAP: Frequently Asked Questions
Medicaid will be offered to new groups of people in Louisiana on July
1st! Read these questions carefully to learn how it may affect you and
your LAHAP coverage.
General Medicaid Information
Who will be eligible for Medicaid?
You will be eligible for Medicaid after July 1st, 2016
and can apply starting June 1st if you:




are aged 19 to 64 years old
don’t qualify for Medicare
meet U.S. citizenship requirements
have a household income less than 138 %
of the federal poverty level (see chart).
Household
Weekly
Size
1
$316
2
$426
3
$536
4
$645
5
$755
6
$865
Bi-Weekly
Monthly
Yearly
$631
$851
$1,071
$1,290
$1,510
$1,730
$1,367
$1,843
$2,319
$2,795
$3,271
$3,747
$16,395
$21,108
$27,821
$33,534
$39,248
$44,961
Do I have to apply for Medicaid or will I get it automatically?
It depends on your situation now. If you have Take Charge Plus or Greater New Orleans Community
Health Connection (GNOCHC) right now, you should have gotten a letter from Medicaid saying that
you get full Medicaid benefits starting July 1st. If you have SNAP, you may have also gotten a letter in
a yellow envelope with 4 questions. If your answer to all these questions is “no” and you contact
Medicaid with your answers, you should get Medicaid automatically. If you aren’t part of one of
these programs or if Medicaid didn’t have an up-to-date address for you, you need to apply to
Medicaid.
How does Medicaid work?
Medicaid is a lot like a private insurance plan. There are 5 Medicaid plans, called “Healthy
Louisiana” plans (you may know them by their old names, “Bayou Health” plans). Each plan has a
network of providers (doctors, nurses, dentists, pharmacies, labs, etc.) and a list of services that they
cover. But, a Medicaid plan is different from a private insurance plan in that you don’t have to pay
anything for your plan except for some small co-pays when you pick up medication. You get to pick
which one of the 5 plans is best for you and your family.
Will my doctor/clinic/pharmacy take Medicaid?
It depends on your doctor, and it depends on what Healthy Louisiana plan you have. Not all doctors
take Medicaid clients. For those that do, remember that there are 5 plans and that not every doctor
takes clients from every plan.
If you have a doctor you like, you can ask them which plans they accept. If you are looking for a
new doctor, you can go to each Healthy Louisiana plan’s website and search for a provider.
Searching each website is better than doing just one search through the Healthy Louisiana website,
because the 5 plans update their own websites more often. Make sure you check to see if they’re
accepting new patients. You can also call each plan and ask about providers near you (you can
find their numbers on Page 1).
Will I have to go to a different case manager if I have Medicaid?
Probably not. You can talk to your case manager to make sure.
The 5 Healthy Louisiana Plans
What are the Healthy Louisiana plans?
Right now there are 5 different Healthy Louisiana plans. They are:
Aetna Better Health
1-855-242-0802
Amerigroup Real
Solutions
1-800-600-4441
AmeriHealth Caritas
1-888-756-0004
Louisiana Healthcare
Connections
1-866-595-8133
UnitedHealthcare
1-866-675-1607
www.aetnabetterhealth.com/louisiana
www.myamerigroup.com/la
www.amerihealthcaritasla.com
www.louisianahealthconnect.com
www.uhccommunityplan.com
The plans are similar in many ways, but there are still some differences. You can compare them sideto-side here.
Which Medicaid plan is the best?
It depends on what’s important to you in a health plan. If you have a doctor you like, a good plan
might be one that has your doctor in their network. Many of the medical and drug benefits are
similar in the 5 plans, but some are a little different- if there are medical services or drugs that are
really important to you, call the plans and see if they cover those services or drugs. Also, each plan
has a Rewards program, which means they offer you money or items such as children’s toys when
you have certain services done. You can compare the plans side-to-side here.
How does Medicaid choose which plan I’m in?
If you fill out the Medicaid paper application, you have the chance to pick your own plan. If you are
automatically enrolled into Medicaid, use healthcare.gov to enroll, or don’t pick a plan on your
application, Medicaid chooses a plan for you. If you had Medicaid in the past, you will be autoassigned to the plan you had before. If you have a child in a plan, you may be assigned to the same
plan that they are in. If Medicaid has any information on your past medical claims they look at which
provider you visited and may assign you to a plan that has that provider.
Can I switch plans if I don’t like mine?
Yes. During the first 90 days of your enrollment you can switch plans for any reason. After that period,
you can switch only in special situations or during a 60-day Medicaid Open Enrollment period once a
year.
Medicaid Coverage and LA HAP
Can I have LA HAP and Medicaid at the same time?
You can’t have both Medicaid and LA HAP at the same time. There are some federal rules that say
programs like LA HAP can’t pay for your care if you have another way of getting it paid for, like
Medicaid. That’s the same reason why LA HAP will soon have new rules about who can get LA HAP
services. If you fit the criteria for Medicaid listed above, you should start applying for Medicaid now
because you will lose your LA HAP benefits:


by September 30th 2016 if you are uninsured or have only dental/vision insurance; or
by December 21st 2016 if you are insured.
If you DON’T fit the Medicaid criteria, your LA HAP benefits will stay the same.
If you get Medicaid, Medicaid will now pay for your medicine and your doctor visits.
I’d rather keep the insurance I have now and not get Medicaid, even if I’m eligible. Can I do that?
Technically yes, but LA HAP cannot help you pay for it. If you are eligible for Medicaid, you are not
eligible for LA HAP.
If you have a Marketplace plan, once you’re eligible for Medicaid you won’t be eligible to get any
tax credits or cost-sharing reductions on your Marketplace plan. So, the plan will be more expensive.
It’s usually not a good idea to keep a Marketplace plan if you can get Medicaid for free instead.
If you have health insurance at your job, you don’t need to sign up for Medicaid if you don’t want to.
But, remember that LA HAP can’t help pay for your plan anymore since you’re eligible for Medicaid.
If you DO sign up for Medicaid, you can keep your job-based insurance and Medicaid can pay your
cost-shares.
I have both Medicare and Medicaid now. Am I going to lose my Medicare or my LA HAP benefits?
No, nothing should change for you. If you have Medicare, Medicare will still pay for most of your
care and Medicaid will pay some extra costs. If LA HAP is paying some other costs for you right now,
such as your Part C premiums or your dental/vision plans, that won’t change—you will still be a LA
HAP client.
If I have Medicaid, will I lose my LA HAP benefits right away?
No. You will get a letter from LA HAP telling you when you will be disenrolled. If you didn’t have
insurance before you had Medicaid, you will have about a month before you’re disenrolled. If you
do have private insurance, you may have a little longer.
Remember that if your LA HAP eligibility has already expired and you didn’t recertify, you won’t be
able to reapply for LA HAP while you have Medicaid.
Now that I have Medicaid, I don’t want to wait to be disenrolled from LA HAP. Can I disenroll right
away?
Yes, just call LA HAP at 504-568-7474 and let them know you want to disenroll right away.
Will LA HAP tell me if I’m disenrolled from their program?
Yes. It’s also important to know that before October, LA HAP will NOT disenroll you until they have
verified that you have full Medicaid. LA HAP shares some data with Medicaid, so they may find out
that you are enrolled. If you are disenrolled from LA HAP because you have Medicaid, LA HAP will
send you a letter letting you know. After that, you will use your Medicaid card to get services and
medicine.
If I have Medicaid, will LA HAP cancel my Marketplace/private insurance plan?
First, remember that you are allowed to have a private plan in addition to having Medicaid—LA HAP
just can’t pay for it. So if you have an employer-based plan or other plan you think you can pay for
yourself, you can do that. If not, and you want your plan to be canceled, you should cancel the
plan yourself when you know your Medicaid is active. If LA HAP is paying the monthly premiums for
your plan, they will stop once you have Medicaid.
If I have Medicaid, I will have copays when I go to the pharmacy. Can LA HAP pay those?
No. LA HAP isn’t allowed to cover you when you have Medicaid, so they can’t pay any copays for
you. If you have trouble paying your copays, talk to your case manager. They may be able to help
you apply for programs that help with expenses besides health insurance, which means you may
have money left over to help with your copays. You should also compare the Healthy Louisiana
plans, especially to see what types of Reward programs they have—you can get money from your
plan if you get certain health services, like immunizations or prenatal visits. The money you get from
these reward programs could help with your copays. Also, not every plan has pharmaceutical
copays so compare them carefully. Finally, if you are at the pharmacy and can’t afford your copay,
talk to your pharmacist. They may have some options or advice for you.
What if my income changes and I lose Medicaid? Can I go back to LA HAP?
If you apply and LA HAP finds you eligible, yes. LA HAP is available to anyone below 400% of the
Federal Poverty Guideline who isn’t eligible for Medicaid. For a single person, this means you make
about $47,500 a year or less. If you lose Medicaid, you can apply to LA HAP again.
If you are in the New Orleans area, you actually have an option through a related program to get
benefits if your income is between 400 and 500% of the Federal Poverty Guideline—to find out more,
contact a community-based organization in New Orleans.
I’m not a legal resident of the United States. Will I lose my LA HAP benefits if my income makes it look
like I’m eligible for Medicaid?
No. But, you should still apply to Medicaid for a couple reasons. First, you may be eligible for some
forms of assistance that you didn’t know you were eligible for. Second, you will need your denial
letter from Medicaid to continue your LA HAP assistance. If you include a Medicaid denial letter with
your application, or if you send the letter to LA HAP while your application is pending or has just been
approved, you can get your full 6 months of eligibility and your LA HAP benefits won’t change.
What if it’s an emergency and I need medication right away? Can I get LA HAP for a short amount of
time while I’m waiting for my Medicaid application to be approved?
Until October, you can continue to sign up for LA HAP benefits even if you are eligible for Medicaid.
Right now, Medicaid is able to review applications very quickly and you should be able to get an
answer soon about your eligibility. After October, you won’t be able to use LA HAP for the short
period when you’re waiting for your Medicaid to be approved so make sure you plan ahead and fill
your medications while you are still an active LA HAP client.
My income is a little too high for me to qualify for Medicaid. Why did LA HAP send me a letter saying I
have to apply to Medicaid in order to get my full 6 months of LA HAP eligibility?
Right now, LA HAP and Medicaid calculate household size and income a little differently. That
means that LA HAP and Medicaid may disagree about your income and whether or not you are
eligible for Medicaid. So, LA HAP considers anyone who earns 150% of the FPL and below to be
potentially eligible for Medicaid. This doesn’t mean you lose your LA HAP benefits. It just means that
you get a temporarily shortened eligibility period which can be extended as soon as you apply for
Medicaid, are denied, and send a denial letter to LA HAP.
On October 1st 2016, LA HAP will be ready to start calculating income the same way that Medicaid
does. Then, you will get your full 6-month LA HAP eligibility if you are above 138% FPL and you will be
referred to Medicaid if you are at 138% FPL and below.
Who do I ask if I have more questions?
 Questions about Medicaid expansion and how Medicaid works: Call Medicaid at 1-888-3426207
 Find out more about LA HAP and Medicaid: Call LA HAP at 504-568-7474 or go to
www.lahap.org/medicaid
 Compare the different Healthy Louisiana plans: Call 1-855-229-6848 or go to
www.healthy.la.gov