Αποτελέσματα Αναζήτησης
Apply online. To apply by phone, call 1-888-342-6207. To apply in person, locate the nearest application center here or Medicaid Regional office here. If applying by mail, download Medicaid application. Completed application can be faxed to 1-877-523-2987 or mailed to: Medicaid Application Office. P O Box 91278.
Online applications shall be submitted in the presence of the applicant. If this is not possible, submit the paper 1A signed by the applicant. The 1A should be submitted by fax using the RightFAX cover which requires the Trusted User to sign indicating adherence to Medicaid guidelines.
Apply for health coverage or renew existing coverage. Apply or renew coverage online at Louisiana Medicaid Online Services. Paper Application and Forms. Application for Health Coverage. Use this form to apply for or renew coverage for all Louisiana Medicaid programs.
You can begin to apply and establish your application date by filling in your name, address and signature below and give this form to us today. It will help us to process your application faster if you also give us a telephone number where you can be reached during the day and provide a copy of a photo ID or other proof of identity.
A Medicaid eligibility application must be completed for all applicants, including those waiver already determined eligible under another category of Medicaid assistance such as Louisiana Children’s Health Insurance Program ( LaCHIP).
The Louisiana Children’s Health Insurance Program (LaCHIP) provides health coverage to uninsured children up to age 19. It is a no-cost health program that pays for hospital care, doctor visits, prescription drugs, shots and more. Click here to apply for LaCHIP.
The following checklist shows all required documents that MUST be submitted to enroll with Fee For Service (FFS) Louisiana Medicaid. Please make certain to complete each required form in its entirety to avoid processing delays.
