If your income recently went up and you’re worried about losing Medicaid, transitional Medicaid could be the lifeline you need. Louisiana offers this temporary coverage to ensure families don’t lose access to healthcare just because they’re moving forward financially.
Want to know more? Read on for a clear breakdown of how transitional Medicaid works in Louisiana, who qualifies, what it covers, and more.
What Is Transitional Medicaid in Louisiana?
Transitional Medicaid Assistance (TMA) is a temporary extension of Medicaid coverage for families who are no longer eligible for Medicaid. This eligibility change is usually due to a raise, more work hours, or a job change.
This mandatory program was created to ensure that beneficiaries don’t instantly lose their insurance after increasing their income. Transitional Medicaid allows eligible families to keep their coverage for up to 12 months. This gives them time to explore longer-term insurance options.
Who Can Qualify in Louisiana?
Transitional Medicaid is mainly for parents or caretaker relatives who have children. To qualify in Louisiana, you must:
- Have been enrolled in Louisiana Medicaid as a parent or caretaker relative
- Have lost your Medicaid eligibility because of earned income (perhaps from a raise or new job)
- Continue living with a dependent child
- Meet basic Medicaid requirements like Louisiana residency
Kids in your household may also qualify for transitional Medicaid if they are no longer eligible under standard children’s Medicaid rules. Children born, adopted, or returning to the home during the transition period may also be covered under TMA.
How Long Does Transitional Medicaid Last?
Transitional Medicaid in Louisiana may provide coverage for up to 12 total months:
- One continuous 12-month period, or
- Two 6-month periods with additional requirements before the start of the last 6 months
For the first six months, there’s no income limit and no asset test. Your coverage will continue no matter how high your income climbs.
During the last six months, families have to:
- Continue working
- Submit any required quarterly income reports
- Keep income below 185% of the Federal Poverty Level (FPL)
Some families may also be required to pay small premiums during this period, depending on how much income they have.
What Does Transitional Medicaid Cover?
In most cases, Louisiana Medicaid transition coverage provides the same comprehensive healthcare coverage you were getting before:
- Doctor visits and preventive care
- Hospital services
- Prescription medications
- Mental and behavioral health care
- Maternity and children’s healthcare
- And more
Louisiana may also help pay for employer-sponsored insurance if it’s available and affordable, while still covering services that the plan doesn’t include.
When Can Coverage End Early?
The transitional Medicaid may end before the full one-year period if:
- You no longer have a child in your household
- Required income reports aren’t submitted on time
- Your income exceeds the allowed limits in the second period
- You haven’t paid your premiums (if required)
Before your transitional coverage ends, Louisiana Medicaid must check whether you qualify for another Medicaid category.
Where to Get Help or Ask Questions
If you’re unsure about your eligibility or next steps, there are a few things you can do:
- Talk to a support coordinator about your income change.
- Contact Louisiana Medicaid Customer Service directly at 888-342-6207 to speak to a representative.
- Pay close attention to notices in your Medicaid online account and letters mailed to you.
So, there you have it – the basics of transitional Medicaid assistance for families in Louisiana. We hope you found all the information you were looking for, and we wish you the best as you navigate all things Medicaid.
