The Family Opportunity Act (FOA) is one of the most invaluable programs offered through Louisiana Medicaid. It opens the doors of opportunity for children with certain disabilities who wouldn’t otherwise have qualified for LA Medicaid or LaCHIP. Could this program help your child? Keep reading to learn the basics of the Family Opportunity Act, including benefits, eligibility requirements, and more.
The Family Opportunity Act Medicaid Buy-in Program
The Family Opportunity Act Medicaid is a plan that covers children with disabilities who belong to families who make too much money to qualify for the LaCHIP program or traditional Medicaid. Instead of securing health coverage through the typical route, families can pay a certain amount to gain access to the Medicaid benefits they need.
Who Does the Family Opportunity Act Apply To?
Could your child get Medicaid benefits through the Family Opportunity Act Medicaid plan?
Your child may be eligible if:
- They have a qualifying disability.
- The family’s income is less than or equal to 300% of the federal poverty level.
For more information about the federal poverty line, read this Louisiana Department of Health resource. The maximum amount of income families can make before being disqualified for the Family Opportunity Act depends on household size. The bigger your family is, the higher the income threshold for eligibility.
The only way to determine your child’s eligibility is to apply for Medicaid on behalf of them. To do that, go to the Louisiana Medicaid Online Application Center and send in an application. If you’d prefer a paper application, feel free to download it and follow the instructions to mail or fax it to the Medicaid Application Office.
What Benefits Are Offered Through the Family Opportunity Act?
The Family Opportunity Act Louisiana plan offers a plethora of benefits to those who qualify. Eligible children gain access to LaCHIP benefits, which cover all of the following:
- Preventive care
- Emergency care
- Immunizations
- Hospitalizations
- Medications
- Transportation
- Therapies (Speech & Language, Occupational, Psychological, etc.)
*This is not a full list of benefits that may be covered for your child under the Family Opportunity Act.
It’s important to remember that Medicaid may set limits on the services your child is eligible for. You may also need to get permission (via a prior authorization) before your child can receive services. Medicaid will need to approve every benefit before it’s provided.
What to Know About the Louisiana Medicaid Application Process
Applying for benefits through Louisiana Medicaid can seem daunting – there are many unknowns. But the more information you have, the better off you’ll be. Here’s how the process typically goes:
- Send in your application via the online portal, mail, or fax. You’ll need identifying information (social security number/document numbers), proof of income (W2 forms, tax statements, etc.), and current health insurance information.
- Wait for Louisiana Medicaid to review and make a determination on your application. You’ll receive communication by mail within a few weeks. If additional information is needed, Medicaid will request it then.
- Follow the next steps outlined in the letter from Medicaid to move forward with the application and enrollment process. Read this article to learn more about what to expect.
If you have any questions about the Louisiana Medicaid application process or the Family Opportunity Act, call the Medicaid hotline at 1-888-342-6207 or email MyMedicaid@la.gov. A representative will be able to answer your questions in detail.
So, there you have it – what the Family Opportunity Act is, eligibility requirements, and more. We hope you found all the information you were looking for, and we wish you the best as you strive to attain the benefits your child needs.
