Medicaid

No-cost insurance for you and your family. Medicaid and LaCHIP benefits to help you get the physical, mental, and substance use treatment services you need to get and stay healthy.

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What you get with Medicaid

24/7 Nurseline

Over 13,000 doctors and providers to choose from
Visits with a PCP you choose
Access to specialist providers from a wide variety of medical specialties
Urgent care
Emergency care

There are no copays for any covered medical services. For a complete list of services and benefits, see your member handbook.

Our 24/7 NurseLine

Fast, free medical advice from a registered nurse anytime, day or night, to get answers to your health questions. Our team is here to help you get the care you need. Call us at 1-866-864-2544 (TTY 711). Our team of registered nurses can help you:

Get answers to your medical questions
Find a doctor or urgent care center near you
Determine how soon you need to get care for an illness or injury

Free dental care

Free adult dental benefits through DentaQuest

Oral exam every six months
X-rays once a year
Teeth cleaning every six months

These services are covered when you use an approved dental care provider. To make an appointment, find a dentist near you or have a question about service limits, visit DentaQuest's website or call 1-844-234-9835 (TTY 1-800-466-7566).

Medicaid Dental Program - Members younger than 21 and adult denture program

Dental Services for Members younger than age 21 and adult members who receive dentures through Medicaid dental program. For details on how to access dental services, visit the websites or call:

DentaQuest EPSDT dental services
Ages 0 - 20
Adult denture program 21 and older
1-800-685-0143 (TTY 800-466-7566) Monday through Friday from 7 a.m. to 7 p.m.
www.DentaQuest.com

MCNA Dental
EPSDT dental services
Ages 0 - 20
Adult denture program 21 and older
1- 855-702-6262 (TTY 800-955-8771) Monday through Friday from 7 a.m. to 7 p.m.
www.mcnala.net

Free vision care

Eye exam once a year
Glasses — including frames and lenses or contacts (up to $100 value) once a year

These services are covered when you use an approved eye care provider. To make an appointment or find an eye doctor near you, call Superior Vision at 1-800-787-3157 (TTY 1-800-735-2258).

Pharmacy and prescription drugs

Medicaid Gets a New Pharmacy Benefit Manager This Fall

Louisiana Medicaid is switching to Magellan Medicaid Administration to manage pharmacy benefits for all Medicaid health plans. This means Magellan will handle authorizations, claims and prescription coverage for all Medicaid health plan members.

If you are in a Medicaid health plan, you should know:

Your pharmacy benefits and co-pays are not changing.
Any prescriptions or approvals you already have are not changing.
Your health plan sent you a letter and new ID card in the mail. The letter said that Magellan would be your new pharmacy benefit manager on October 28, 2023. That start date has been moved to October 28, 2023.
You can use your new health plan ID card to fill your prescriptions beginning October 28, 2023.
Most pharmacies will be in Magellan’s network. If your current pharmacy is not, Magellan will contact you by mail.

Beginning October 23, 2023, you can contact Magellan’s 24/7 Help Desk with questions about the transition. Effective, Saturday, October 28, 2023, the help desk will be available to assist with inquiries relating to pharmacy and or prescription questions. You can call 1-800-424-1664 (TTY: 711) or visit www.lamcopbmpharmacy.com.

Learn more

Mental health and substance use services

Being healthy is about more than just your body, so our benefits help you with your emotional and mental health, too. This includes mental health and substance use treatment services.

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Your Care Plan

We put tools and technologies in your hands to make it easier to access care and services. Your Care Plan is a tool for Healthy Blue members getting case management services. It helps you:

Stay connected with your case manager
Get your care coordinator’s phone number and email address
Send secure messages about diagnoses, goals, medicines, services and more
View your goals and objectives
Check due dates and status for goals and objectives

Learn more

Is Medicaid right for you?

Medicaid

In Louisiana, you are eligible for Medicaid if you:

Receive Supplemental Security Income (SSI).
Receive financial help from the office of family support (OFS) through the family independence temporary assistance program (FITAP).

You may also be eligible for Medicaid if you:

Are disabled according to the Social Security Administration’s definition.
Have corrected vision no better than 20/200.
Are a low-income parent of children under age 19.
Are a child under age 19.
Are pregnant.
Have no insurance and need treatment for breast or cervical cancer.
Receive Medicare coverage and are low-income.

Children’s Medicaid option

Children younger than 19 who may not be eligible for Medicaid may qualify for the children’s Medicaid option if they meet these eligibility requirements:

Have a disability (severe physical or mental limitations which lasts at least one year, or results in end of life)

Meet the level of care given at a nursing home, a hospital, or an intermediate care facility for people with intellectual disabilities

Can be cared for safely at home

Can be cared for at home for less cost than in an institution

Medicaid Expansion

You may be eligible if you:

Are between 19 and 64 years old
Meet citizenship requirements
Don’t already qualify for Medicaid or Medicare
Make less than 138% of the federal poverty level

Learn more about Medicaid expansion

Get the most out of your health care

New to Healthy Blue?

As a new member, we know you have questions. We also know you’re short on time! Learn the basics about your health plan in these videos.

View videos

Key member resources

Earn money by taking care of yourself

Healthy Blue covers extra benefits eligible members cannot get from fee-for-service Medicaid. These extra benefits are called value-added services. We offer the following:

Free adult dental care for members over age 21
- Dental exams and cleanings (twice a year)
- X-rays (once a year)
To make an appointment or find a dentist near you, call DentaQuest at 844-234- 9835 (TTY 800-466-7566) or MCNA Dental at 855-702-6262.
- Free adult vision care
  - Eye exam (once a year)
  - Glasses — ncluding frames and lenses or contacts (up to $100 value) once a year
To make an appointment or find an eye doctor near you, call Superior Vision at 800-787-3157 (TTY 800-735-2258).
- Tobacco and vaping cessation for members ages 11 years and older. The program includes:
  - A plan for quitting
  - Peer support
  - Live chat coaching
  - Educational and supportive text messaging
  - Medication to help you quit
- Newborn circumcisions.
Healthy Rewards
Healthy Rewards is a no-cost, optional program for health plan members. The program encourages you to get the care you need to create a healthy lifestyle and then rewards you with gift cards to popular retailers. You may be eligible to earn rewards for some of the activities below:
- Prenatal and postpartum visits
- Annual wellness visits for adults and kids
- Cancer screenings
- Diabetes care
- Vaccines
- Medication refills
- Completing an annual health screener
Enroll and earn rewards

Enroll in Healthy Rewards by logging in to your Healthy Blue account and visiting the Benefit Reward Hub to see what you’re eligible to earn. You can also enroll in the program or learn more by calling Healthy Rewards at 888-990-8681 (TTY 711), Monday through Friday from 8 a.m. to 7 p.m.

Programs and incentives for pregnant women and new parents:
- $25 for pregnant members and new parents with our New Baby, New Life^SM program who go to a prenatal visit in their first trimester or within the first 42 days of enrollment.
- $50 for new parents for going to their postpartum visit 7-84 days after delivery.
- Free portable crib or infant car seat for going to seven or more prenatal doctor visits.
- Maternal and Early Childhood Visiting program — a program for actively enrolled members to get value-added benefits to improve pregnancy outcomes. Benefits include:
  - Referrals to the Nurse Family Partnership or Healthy Start.
  - In-home visits to provide guidance on preventive health services, prenatal and postpartum healthcare services from healthcare providers, nutrition and health-harming factors, along with information that will focus on your child’s physical and mental health development.
  - Family planning kit with condoms, pregnancy test, prenatal vitamins, and more.
  - In-home postpartum visit and counseling.
  - Home delivered meals for postpartum members with gestational diabetes.
  - Transportation to and from supported services like Lamaze, doula birthing appointments, and more.
- My Advocate^® — a program for eligible pregnant members to get tips on how to have a healthy pregnancy. Eligible new parents will also get tips on caring for their new baby.
- Circumcisions for newborns.
- Breastfeeding support kit.
Healthy lifestyle and weight management programs:
- Booster seat after completing required well-child visits.
- *WW^® (formerly known as Weight Watchers^®) vouchers – 13-week membership to the program.
- Healthy Families — a program to help families get fit and stay healthy.
Community outreach and support — helping you access care and services beyond what is traditionally covered by the plan.
- Outreach events in the community at set times.
  - Free community back-to-school drives
  - Free community baby showers
  - Community health educators
  - Community diaper drives
- A free cellphone with free monthly minutes, data, and text messages.
- Healthy Home program — having unhealthy living conditions in your home can have a big influence on your health. Healthy Blue has a program to help you and your family stay healthy by fixing or getting rid of those problems that may be causing unsafe housing conditions. A Healthy Blue team member will help determine your eligibility and connect you to our program to start your services. Services include:
  - Home remediation
    - An assessment of your home
    - Healthy Home Case Management to make sure your needs are met
    - Education about having a healthy home
    - Basic home repairs and pest control
    - Home Safety Benefits such as a CO2 detector, smoke alarm, fire extinguisher, etc.
    - Utility assistance
    - Rental assistance
    - Legal aid
    - Smoking cessation
    - Help with finding new housing, if necessary
- Asthma intervention program to address home-based, environmental asthma triggers. Open to all members diagnosed with asthma. Active participation in case management asthma program required. The program has two levels including up to $200 for asthma mitigation supplies.
Online resources:

Community Resource Link: Need help finding housing, rides, work, or more? Community Resource Link is a site where you can search for free or low-cost local services. This easy-to-use search tool can help you find services and resources in your area. You just have to enter your ZIP code and select the type of service you’re looking for. It’s that easy! To learn more, visit myhealthybluela.com and select Community Resources or call 844-521-6941 (TTY 711).

We give you these benefits to help you be as healthy as you can.
* Weight Watchers is the registered trademark of Weight Watchers International, Inc.