Louisiana's Children's Health Insurance Program: At a Glance
| Implementation Date |
n/a |
June 1, 2008 |
| Program Type |
Medicaid expansion |
Separate program |
| Income Range and Population |
Children up to age 19 with family incomes up to 200% of the FPL; called LaCHIP Does not provide health coverage to immigrants who are not eligible for coverage under Medicaid/SCHIP. |
Children up to age 19 with family incomes between 200% and 250% of the FPL (enacted legislation would have covered children with family incomes between 200% and 300% of the FPL but due to the CMS Directive the state scaled back the program) |
| Cost-Sharing |
No cost-sharing provisions |
Monthly premiums ($50/family); co-insurance based on a percentage of the charge; no co-pays for well-baby, well-child, or vaccinations; annual cap on out-of-pocket costs at 5% of family gross income |
Enrollment/Renewal Procedures
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| Application |
Mail-in or web-based application; no face-to-face interview or asset test required |
Same application and enrollment process |
| Continuous Eligibility |
12 months |
12 months |
| Renewal |
No face-to-face interview or asset test required; can renew by phone with caseworker or through automated system/web; ex-parte renewal process, utilizing existing data to determine eligibility for another 12 months from date of renewal |
Same renewal form and procedures |
| Crowd-out Measures |
No waiting period |
12-month waiting period, unless they qualify for limited "good cause" reasons |
| Presumptive Eligibility |
Enacted, but not yet implemented |
Enacted, but not yet implemented |
Benefits
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| Benefits |
Covers doctor visits, hospital care, immunizations, vision, prescriptions, dental, mental health, and substance abuse |
Covers doctor visits, hospital care, immunizations, prescriptions, mental health, and substance abuse; no dental or vision benefits |
| Service Delivery System |
Most low-income beneficiaries are required to participate in CommunityCARE, where they are linked with a PCP who serves as a medical home |
Same service delivery system |
Other Provisions
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| Outreach |
Nine staff members spend 100% of their time on outreach; hundreds of other state eligibility employees undertake ongoing outreach; state contracts with 11 local entities |
State may contract with additional local entities to assist with outreach and enrollment |
| Premium Assistance |
Louisiana Health Insurance Premium Payment (LHIPP) will pay for some or all of the health insurance premiums if health insurance is available through their job, someone in the family has Medicaid, and if it is cost effective to the state |
Same premium assistance program |
Last Updated: January 2009
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