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a member’s guidea member’s guideto coverage, servicesto coverage, services
and supportsand supports
MPP Member Guide
Introduction
What is the Medicaid Purchase Plan?
Louisiana’s Medicaid Purchase Plan is health coverage that’s available only to people with disabilities who work. The monthly cost or “premium” is based on your countable income – not your age or health condition.
This program is not a family health plan. It only provides health care coverage to you. For this reason, the income and assets of your family members, including your spouse or parents, are not counted.
This program is part of the Ticket to Work and Work Incentives Improvement Act of 1999 which provides training, health care and other supports that help people with disabilities who work to achieve independence. The Medicaid Purchase Plan allows you to:
• Earn more and• Save more and Keep health care coverage.
What is the MPP Member Guide?This guide is a reference book that was developed to help you understand MPP, its benefits and services. It also includes information on other disability supports and services to provide you with tools to make employment ‘work’ for you.
You can always get the most up to date copy of this guide at www.LaMPP.org. If you need this book in another language or another format, like Braille or large print, call us at 1-888-544-7996.
How do I use this guide?
It may be helpful for you to read the guide from start to finish; then read sections as you need specific information.
See Resources for more information about
Ticket to WorkTicket to Work
January 2009
MPP Member Guide
To help you use this book, it: has a color-coded Table of Contents that identifies all the topics
covered in the guide is divided into sections that match the colored listing in the Table of
Contents includes a description of common abbreviations used in this guide and
in other materials you may receive highlights important information in square red boxes like the sample
shown here
provides references to additional information about topics in rounded boxes that match the color of the
section as shown in the sample here
includes two sections, Helpful Contacts and Resources, which contain information that may be useful in your work efforts
The folder that came with this guide can be used to hold important papers. For example, the pockets in the folder can hold:
your Medicaid insurance card important letters from Medicaid, Social Security or others who provide
services to you money order receipts for your premium payments other important documents like your Social Security card, birth
certificates, and insurance papers
You can set this folder up to fit your own needs by using the clear tabs and blank white labels that are included in the way that you choose.
The folder holds a pocket-sized expandable card which you can use to list your personal identification, emergency contact, doctor and other medical provider contact information. You may want to take this card or the folder with you if you have to leave your home in an emergency situation, such as a hurricane.
Sample of square red boxesthat include important information
Sample of color-coded boxes that refer to the section where you can find additional
information
MPP Member Guide
January 2009
Table of ContentsMPP Member Guide
Table of ContentsAbbreviations and AcronymsWhat do the abbreviations in the guide mean? i
EligibilityWhy do I get the Medicaid Purchase Plan?
1DisabilityAgeEmploymentIncomeAssetsPremiums
Can Medicaid Purchase Plan cover my medical bills from before I applied? 3
Your Medicaid RightsWhat are my rights?
5Fair HearingsEqual Treatment 6
Your Responsibilities to MedicaidWhat are my responsibilities? 7
Reporting ChangesPaying Premiums
Covered Services What does the Medicaid Purchase Plan cover?
9How do I access these services?
11What do I do if I need a new Medicaid card?What is CommunityCARE?
13
PremiumsDo I have to pay a premium for Medicaid Purchase Plan?
15How will I know how much I owe?
January 2009
MPP Member Guide
How can I pay my premium?Where do I send my payments?
16When are my premium payments due?What happens if my payment is not received?
17Can my employer or someone else pay my premium for me?
What happens if there is a change in my situation that affects the amount of my premium?Can I get a refund if I paid too much?What should I do if I don’t want to pay for Medicaid Purchase Plan?
Other Health InsuranceCan I have other health insurance? 19How does Medicaid work with my other insurance?Can I get help with my other insurance premiums?
Medicare Savings ProgramsMedicare Prescription Drug Plans20LaHIPP
MPP ServicesMedicaid Purchase Plan Services
21Medicaid Purchase Plan Services for persons under age 21
28
Medicaid Infrastructure Grant Advisory Council What is the Medicaid Infrastructure Grant (MIG) Advisory Council?
31
Helpful ContactsMedicaid Purchase Plan Coordinators
33Medicaid Parish Offices 35Statewide Contacts
45
ResourcesKnowing Your Rights 49Looking for a Job 51Social Security Work Incentives
53Supports to Work 55
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MPP Member Guide
Taxes 57Ticket to Work 59
Abbreviations &
Acronym
s
MPP Member Guide
Abbreviations and Acronyms
What do the abbreviations in the guide mean?
The following list of abbreviations may help you understand this guide and other information you get from Medicaid, Medicare, Social Security or any other agency that provides services and supports to you and other people with disabilities.
BHSF – Bureau of Health Services Financing
CMS – Centers for Medicare and Medicaid Services
COBRA – Consolidated Omnibus Budget Reconciliation Act of 1985
COLA – Cost of Living Adjustment
CWIC – Community Work Incentives Coordinator
DHH – Louisiana Department of Health and Hospitals
EITC – Earned Income Tax Credit
EIE – Earned Income Exemption
EPSDT – Early and Periodic Screening, Diagnosis, and Treatment
FBR – Federal Benefit Rate
FICA – Federal Insurance Contribution Act
FPL – Federal Poverty Level
HIPAA – Health Insurance Portability and Accountability Act
IRA – Individual Retirement Account
IRS – Internal Revenue Service
LaHIPP – Louisiana Health Insurance Premium Payment Program
LDOL – Louisiana Department of Labor
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MPP Member Guide
LIS – Low Income Subsidy
LRS – Louisiana Rehabilitation Services
LT/PCS – Long Term Personal Care Services
MEDT – Medical Eligibility Determination Team
MPP – Medicaid Purchase Plan
MSP – Medicare Savings Programs
MVA – Medical Vendor Administration
NEMT – Non-Emergency Medical Transportation
PAS – Personal Assistance Services
PAU – Prior Authorization Unit
PCA – Personal Care Attendant
PCP – Primary Care Physician
PDP – Prescription Drug Plan or Medicare Part D Plan
PHI – Patient Health Information
QMB – Qualified Medicare Beneficiary
RSDI – Retirement, Survivors and Disability Insurance (Social Security)
SGA – Substantial Gainful Activity
SLMB – Specified Low-Income Medicare Beneficiary
SSA – Social Security Administration
SSDI –Social Security Disability Insurance
SSI – Supplemental Security Income
SSN – Social Security Number
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Page ii
Abbreviations &
Acronym
s
MPP Member Guide
TPL – Third Party Liability
UCB – Unemployment Compensation Benefits
VA – Veterans Administration
WIPA – Work Incentives Planning Assistance
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Page 1
Eligibility
Eligibility
Why do I get the Medicaid Purchase Plan?
You have a qualifying disability. This means:
you get Social Security Disability Income or you recently lost Supplemental Security Income (SSI) or you have Medicare or Medicaid Eligibility Determination Team doctors have decided that
your condition meets the Social Security definition of disability
You are at least age 16 but have not yet reached age 65.
You are currently employed or self-employed, either part-time or full-time.
See D If you lose your job you may be able to keep ability Resources for helpful information on Looking for a Job)
Your current countable monthly income is less than $2167 through March 2009.
To figure your countable income, we consider: less than half of the money you earn (work for) and all but $20 of any other money you get, such as Social Security or
Veterans benefits
If you have no unearned income like Social Security, you can earn up to $4399 monthly through March 2009.
In order to get and keep Medicaid Purchase Plan, your earnings must be reported to the Internal Revenue Service (IRS) or Louisiana
Department of Revenue (LDR) and you must pay all state, federal or payroll taxes that you
owe.See Resources for helpful information
about TaxesTaxes
January 2009
The income of family members, including your spouse or parents, is not counted.
Income limits go up each year in April. You can always get the current income limit at
www.LaMPP.org.
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Your countable assets are less than $25,000.
Assets are resources like: cash, bank accounts, stocks, or bonds vehicles, including cars, trucks, boats property and anything else you own
Assets that we do not count are: your home one vehicle life insurance policies medical savings accounts retirement accounts and your spouse’s share of any community property
You pay a premium if your countable monthly income is more than $1300 through March 2009.
June 2008January 2009
See Premiums for additional information
The resources of your family members, including
your spouse or parents, are not counted.
Income limits go up each year in April. You can always get the current limit at
www.LaMPP.org.
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Eligibility
Can Medicaid Purchase Plan cover my medical bills from before I applied?
MPP can cover your medical bills from as far back as 3 months before you applied. Be sure to let Medicaid know if you have medical bills for this time.
If you do not have to pay a premium for MPP, your coverage is starting as soon as possible based on what you told us.
If you have to pay a premium for MPP, your coverage is starting the month after you are approved. If you want coverage for the month you are approved and for as far back as 3 months before you applied, you must pay for all months before you can get this extra coverage.
See Premiums for additional information
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Page 1Rights
Your Medicaid Rights
What are my rights?
You have the right to ask for a Fair Hearing (also called an Appeal) if you think any decision we make is unfair, incorrect, or is being made too late. You may also appeal a Medicaid decision if any services you ask for are denied, if you are offered different services than you request or if the service provider does not ask for approval from Medicaid for the full amount of services you request.
To ask for a hearing, write to or call Medicaid at 1-877-252-2447. You may also write to or call:
DHH Bureau of AppealsPO Box 4183Baton Rouge, LA 70821-4183Phone: 225-342-0443Fax: 225-342-8773Email: [email protected]
Fair Hearings are usually done by telephone at the local Medicaid office. If you ask, you may be able to get a hearing in person with the Appeals judge.
If you need more information about your hearing rights, contact Medicaid at 1-877-252-2447 and ask for BHSF Flyer Fair Hearings.
You have 30 days from the dateof the notice that explains the action being
takento ask for a Fair Hearing.
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You have the right to equal treatment. Louisiana’s Medicaid Program is an equal opportunity program. You can’t be treated differently because of your race, color, sex, age, disability, religion, nationality or political belief.
If you think we have treated you differently: call the U.S. DHHS Regional Office for Civil Rights in Dallas, Texas at
1-800-368-1019 or write to or call Medicaid at 1-877-252-2447 or write directly to:
Department of Health & HospitalsPO Box 4818Baton Rouge, LA 70821-4818
See Resources for helpful information on Knowing Your RightsKnowing Your Rights
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Responsibilities
MPP Member Guide
Your Responsibilities to Medicaid
What are my responsibilities?
You have a responsibility to report changes and must let us know within 10 days if:
you quit or lose your job, work more or less hours, or have changes in pay
there are changes in any other money you get, such as if you start getting or lose Social Security benefits
there are changes in other health coverage, such as getting or losing Medicare or private health insurance, or in the amount you pay for other health insurance
your address, phone number, or email address changes there is an increase in your assets that makes the value more than
$25,000
Changes in your income and other health insurance costs that you pay affect the amount of your MPP premium. If you do not report these changes to Medicaid within 10 days, you may:
lose your right to any refund or have to pay premiums for coverage you already received
You must pay a premium for any month that your countable income is more than $1300. If you do not pay the premium, your Medicaid coverage will stop.
If you lose your job, you may be able to keep Medicaid Purchase Plan coverage for up to 6 months, as long as you plan to go back to work. If you are not working after 6 months,
your MPP coverage will stop.
See Resources for helpful information about
Looking for a JobLooking for a Job
July 2008
See Premiums for additional information
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Income limits go up each year in April. You can always get the current limit at
www.LaMPP.org.
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Covered Services
What does the Medicaid Purchase Plan cover?
MPP covers the same services that regular Medicaid provides. It does not cover special services available only through Medicaid Waiver Programs.
Services covered by MPP include: Audiology (hearing services) Chemotherapy Dentures (one set every 7 years) Doctor visits (a limit of 12 visits per year for people over age 21) Eye care Family planning (if you are female) Hemodialysis Home health care Hospice services Hospital services (inpatient, outpatient and emergency room) Lab and X-ray tests Long Term Personal Care Services Medical equipment, appliances, and supplies Medical transportation (emergency and non-emergency) Mental health clinic services Mental health rehabilitation Nurse Midwives Nurse Practitioners Prenatal care (if you are pregnant) Prescription drugs (unless you have Medicare) Podiatry services (foot care) Psychiatric hospital care Sexually Transmitted Disease (STD) Clinic services Support Coordination services (if you have HIV) Therapy services (Occupational, Physical, Speech, Language and
Hearing) Tuberculosis Clinic services
Medicaid does not cover every medical service.
Before you get services, ask the provider if they take Medicaid as payment for their
services. Be sure to ask about limits and co-payments.
Some services and equipment must be approved by Medicaid before you get them.
Covered Services
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If you are under age 21, these services may also be covered: Chiropractic services Dental care Extended home health services Eyeglasses Hearing aids KIDMED - immunizations, medical, dental, vision, and hearing
screenings Personal care services Psychological tests and therapy Substance Abuse Clinic services and any other medically necessary health care, diagnostic services, and
treatment
If you have Medicare, you must get your drug coverage from a Medicare Prescription Drug (Part D) Plan. If you do not already have Medicare Part D, you must sign up with a plan or you will not have drug coverage.
Medicaid Purchase Plan helps you with Medicare Part D in the following ways: Your monthly Part D premium is covered up to $24.62 in 2008. If you
have or choose a plan that has a higher cost you must pay the difference.
You will not have a deductible (the amount you pay each year before Medicare begins paying for drugs).
You will not have to pay anything for your prescriptions if you live in a group home, institution or nursing home.
If you live anywhere else, you will pay between $1.00 and 5.00 for each prescription.
You will not have a gap in drug coverage like people who only have Medicare.
You can change Medicare Part D plans if you need to do so more than once a year. If you choose to change, your new plan will take effect the month after you switch.
Call 1-800-644-4227 or visit www.medicare.gov if you need more information.
See MPP Services or visit www.La.MPP.org
for specifics on covered services andwhere to find a doctor or dentist
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See Other Health Insurance for information about how Medicaid works with
other insurance
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See Resources for more information about Supports to WorkSupports to Work
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2MPP Member Guide
How do I access these services?
You will get an insurance card known as Health Network for Louisiana. You need to take this card with you when you go to a doctor, hospital, pharmacy, or other medical provider to receive services. Carry your card with you at all times to make sure that you have your card if you need emergency medical care.
You must show your card every time you receive services so that the doctor, hospital, pharmacy, or other provider can verify your current eligibility. You must let the provider use your card to verify your eligibility. Do not let a provider keep your card.
What do I do if I need a new Medicaid card?
If you need a new Medicaid card because your name changes or because your card is lost, damaged or stolen, call the toll-free telephone number at 1-800-834-3333 immediately. This will help you get a new card as quickly as possible and could help prevent unauthorized use of your card.
If your Medicaid card has to be replaced for any reason, it will take up to 10 days for you to receive a new one. If a provider is not able to verify your eligibility, you may not be able to get medical services until you receive your new card.
Keep your card safe fromdamage, loss or theft.
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Covered Services
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What is CommunityCARE?
It is Louisiana Medicaid’s managed care system that connects you with a Primary Care Physician (PCP). Your PCP will:
handle your health care by providing education, preventive and acute care
refer you to specialists when needed admit you to the hospital share your medical information with the emergency room and other
authorized health care providers and arrange for you to have medical coverage 24-hours a day, 7 days a
week
You are not required to participate in CommunityCARE if you: have Medicare have other health insurance with physician benefits, including HMOs are a Native American Indian or an Alaskan Native and are a member
of a federally recognized Native American tribe live in a nursing facility
If you are required to participate in CommunityCARE, you will get a letter asking you to choose a PCP. You can pick your PCP from the following types of providers:
Family Practice General Practice Pediatrics Internal Medicine Obstetrics/Gynecology Clinics
Call 1-800-259-8000 or visit www.LaMPP.org to get a list of PCPs.
If you do not choose a PCP, one will be assigned to you.
You get the same services covered by Medicaid, whether or not you are required to participate in CommunityCARE.
If you do not use the PCP you selected or that was assigned to you, you may not be able to get services and, even if you do, the provider will not be paid by Medicaid.
If you need an exemption for medical reasons, write to:
DHH CommunityCARE ProgramP.O. Box 91030Baton Rouge, LA 70821
The request form is available atwww.la-communitycare.com
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Covered Services
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Premium
sMPP Member Guide
Premiums
Do I have to pay a premium for Medicaid Purchase Plan?
You have to pay a premium for any month through March 2009 that your countable income is more than $1,300.
Your Medicaid worker figures how much of your income is counted and how much your premium for Medicaid Purchase Plan will be based on this chart.
Premium Chart April 2008 - March 2009 Countable Monthly Income Premium less than $1300 $0 $1300 to $1733 $80 $1734 to $2167 $110
To figure how much you have to pay for MPP, we deduct: more than half of the money you earn (work for) and $20 from any other money you get, such as Social Security or Veterans
benefits plus any Medicare or other health insurance premiums that you pay
How will I know how much I owe?
When you were approved for MPP, you got a certification letter that let you know the amount of your premium. Any time there is a change in the amount of your premium, you get a notice of the new amount.
You also get a bill for every month that you owe a premium. The bill is mailed to you on the second to last work day of every month.
How can I pay my premium?
Your premium payments must be made by money order or by automated bank draft made out to Medicaid Purchase Plan. Contact your bank or credit union directly for
July 2008
These limits go up each year in April. You can always get the current amounts at
www.LaMPP.org.
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information on their process for bank drafts. Do not send personal checks or cash to us for your payment.
Where do I send my payments?
Please use the payment envelope that comes with your bill each month. If you lose the payment envelope, send the payment to:
MPP Premium UnitPO Box 91278Baton Rouge, LA 70821-9893
Do not take or mail the payment to your local Medicaid office as this will delay crediting of your payment.
When are my premium payments due?
The dates your premiums are due are always shown on your bill.
Initial Premium - When you first get MPP, two premiums are due by the 10th of the month after you are approved. This payment covers your first and second months of MPP.
Prior Coverage Premium - If you asked for coverage for the month you are approved and for any months before then, you must pay for all months before you can get this coverage. This payment is due 30 days from the date of the bill.
On-going Premiums - Regular premium payments are due by the 10th of the month before the coverage month. (For example, payment is due by June 10 for July coverage.)
Change Premium - At least two premiums are due by the 10th of the month after any change that results in an increase in your premium. The number of months due will depend on whether or not you reported the change to us timely.
Be sure to keep your money order receiptor proof of bank draft payment in case your
payment is lost or not received by us. Use the folder that came with this guide
to keep your receipts.
Always mail your payments at least 7 days before they are due to avoid late payments or possible cancellation of your coverage.
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Premium
sMPP Member Guide
What happens if my payment is not received?
If we do not get your payment by the due date on your bill, you will get a notice telling you that your Medicaid coverage will stop at the end of the month. If your payment is received before the end of the month, your Medicaid coverage will not end.
If you sent your payment before the deadline, provide a copy of the money order or payment receipt to your local Medicaid office. You also need to ask the company or bank to put a tracer on the payment. Your Medicaid coverage will not stop while the payment is being traced.
Can my employer or someone else pay my premium for me?
Yes. Anyone, including your employer, can pay your premium for you but the bill will be sent to you each month. If someone else pays for you, make sure that the payment is made and that it is paid on time.
What happens if there is a change in my situation that affects the amount of my premium?
Changes in your income and other health insurance costs paid by you affect the amount of your MPP premium. You must report these changes to Medicaid within 10 days.
Can I get a refund if I paid too much?
We will make refunds to you only if: you paid for a month for which you are not covered your income decreased or your expenses increased and you reported
the change to us within 10 days we made a mistake in the calculation of your premium amount
What should I do if I don’t want to pay for Medicaid Purchase Plan?
At any time you decide you don’t want to buy MPP, contact Medicaid at 1-877-252-2447 immediately and ask that your Medicaid be stopped.
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If your MPP coverage has been ended fornon-payment of premiums,
you must pay any outstanding balance before you can get Medicaid Purchase Plan
again.
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Other
Healt
hInsurance
MPP Member Guide
Other Health Insurance
Can I have other health insurance?
Yes, you can have other health insurance, including Medicare, in addition to MPP.
In fact, you must take other health insurance coverage that you can get at no cost to you, such as Medicare Part A and some health insurance provided by employers, to get or keep Medicaid Purchase Plan. This helps Medicaid save on the amount we pay for your health care costs.
No insurance, including MPP, covers every medical expense. If you have high health care costs, it may be in your best interest to have more coverage, even if you have to pay for it.
How does Medicaid work with my other insurance?Medicaid requires that you use any other insurance you have to pay for your medical care before Medicaid pays. Medicaid will pay only when the provider accepts both Medicaid and your other insurance from you.
Can I get help with my other insurance premiums?
Louisiana’s Medicaid Program may be able to help with the cost of your premiums for Medicare and other group health insurance.
Medicare Savings Programs can pay your Medicare Part B premium which usually costs $96.40 a month in 2008.
If you are single: your countable monthly income must be less than $1040, and your assets must be less than $4000
If you are married: countable income for you and your spouse must be less than $1400,
and your assets must be less than $6000
These limits go up each year in April. You can always get the current amounts at
www.MSP.DHH.Louisiana.gov.
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If you have Medicare coverage, your prescription drugs will be covered through a Medicare Prescription Drug Plan. In 2008, Medicaid will pay up to $27.48 monthly for your Medicare Prescription Drug (Part D) insurance. If you picked a plan that is higher than this cost, you must pay the amount over $27.48. The amount that Medicaid will pay for Medicare Part D insurance changes every year in January.
We may also be able to help with the cost of premiums for your individual or family health insurance from a job through LaHIPP if it is ‘cost-effective’. Cost effective just means that it would cost less for Medicaid to pay all or part of your health insurance premium than it would be for us to pay for all of your medical expenses. If you want more information about this benefit, contact Medicaid at 1-877-252-2447 and ask for BHSF Flyer LaHIPP.
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Call 1-800-644-4227or visit www.medicare.gov to get the
current Part D amount covered by Medicaid.
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Medicaid Purchase Plan Servicesvisit www.LaMPP.org for current service and provider
informationCoveredServices
Who isEligible
Where toAccess
ServicesLimits
Audiology(hearing services) professional medical
services including audiologist services
hearing tests
Anyone with Medicaid
Audiologist Services may require Prior Authorization. Provider will submit Prior Authorization request.If you are 21 or older, hearing aids are not covered.
Chemotherapy chemotherapy
administration treatment drugs
prescribed by doctor
Anyone with Medicaid
Hospital
Doctor
ClinicDentures dentures denture relines denture repairs exam and X-rays for
construction of a denture authorized by Medicaid
Anyone with Medicaid 21 years of age or older
Dentist All services, other than repairs, require Prior Authorization. Dentist will submit Prior Authorization request.Only one complete or partial denture per arch is allowed in a 7-year period. The partial denture must oppose a full denture. Two partial dentures are not covered. Additional guidelines apply.
Doctor Visits professional medical
services including physician services
Anyone with Medicaid
Doctor
Clinic
Some services require Prior Authorization. Provider will submit Prior Authorization request.Services are subject to limitations and exclusions. Your healthcare professional can help you with this.If you are 21 or older, you are limited to 12 visits per year unless an extension is granted. Your healthcare professional must request an extension.
MPP
Services
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CoveredServices
Who isEligible
Where toAccess
ServicesLimits
If you are under 21, there is no limit to the number of visits.
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CoveredServices
Who isEligible
Where toAccess
ServicesLimits
Eye Care exams and
treatment of eye conditions, such as infections or cataracts if you are 21 or older
exams and treatment of eye conditions, including exams for vision correction or refraction error if you are under 21
Anyone with Medicaid
Optometrist
Ophthalmologist
Optical Supplier
If you are 21 or older, these services are not covered: routine eye exams for
vision correction routine eye exams for
refraction error eyeglassesIf you have Medicare, some vision services may be covered. Contact Medicare for more information.
Family Planning Services doctor visits nurse visits doctor counseling
about sterilization nutrition counseling social services
counseling contraceptives lab services
Any female between the ages of 10 and 60 with Medicaid
Family Planning Clinic
Doctor
Services that are not for routine family planning services are not covered. Provider should make referrals for other medical problems.These services are not available to pregnant women.
Hemodialysis dialysis treatments lab services medically necessary
injections
Anyone with Medicaid
Dialysis Center
Hospitals
Home Health Care intermittent/part-
time nursing services including skilled nurse visits
aide visits physical,
occupational, and speech / language therapy
Anyone with Medicaid
Doctor You must have doctor’s prescription and signed plan of care.Therapy services require Prior Authorization.
Hospice Services Medicare allowable
services
Anyone with Medicaid and Medicare
Hospice Provider
Doctor
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CoveredServices
Who isEligible
Where toAccess
ServicesLimits
Hospital Services -Inpatient inpatient hospital
care for illness or injury which can only be provided in a hospital setting
basic services that a hospital provides
Anyone with Medicaid
Doctor
Hospital
Inpatient hospitalization requires Pre-certification and Length of Stay assignment. Hospital will submit Prior Certification request.
Hospital Services - Outpatient diagnostic and
therapeutic outpatient services
outpatient surgery and rehabilitation services
therapeutic and diagnostic radiology services
chemotherapy Hemodialysis
Anyone with Medicaid
Doctor
Hospital
Outpatient rehabilitation services require Prior Authorization. Provider will submit Prior Authorization request.
Hospital Services - Emergency Room
Anyone with Medicaid
Doctor
Hospital
If you are 21 or older, you are limited to 3 emergency room visits per year unless you are in CommunityCARE.
Lab Tests and X-Ray Services diagnostic testing
and X-Ray services ordered by a doctor
Anyone with Medicaid
Doctor Portable x-rays are covered only if you are unable to leave your home without special transportation or assistance to get x-rays.
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MPP
Services
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CoveredServices
Who isEligible
Where toAccess Services Limits
Long Term Personal Care Services (LT-PCS) basic personal care
-toileting & grooming
assistance with eating and food preparation
assistance with bladder and/or bowel requirements or problems
performance of incidental household chores for you
accompanying you to medical appointments
grocery shopping, including personal hygiene items
Anyone with Medicaid age 21 or older who: requires
assistance with at least one Activity of Daily Living
meets the medical need for admission to a nursing facility and imminent risk criteria
is able to direct the care given by the worker with or without help
Office of Aging and Adult Services (OAAS) Contact Affiliated Computer Services at1-877-456-1146
This service requires Prior Authorization.LT-PCS does not: cover medical tasks
such as medication administration or tube feedings
provide supervision if you cannot be left at home alone
replace existing family or community supports
provide respite for a primary caregiver
Medical equipment, appliances and supplies (Durable Medical Equipment or DME) medical equipment
and appliances such as wheelchairs, leg braces
medical supplies such as ostomy supplies
Anyone with Medicaid
Doctor
DME Provider
All services must be prescribed by a physician and must be Prior Authorized.Provider will request Prior Authorization.If you are 21 or older, diapers and blue pads are not covered.
Medical Transportation – Emergency
Anyone with Medicaid
Emergency ambulance providers
Emergency ambulance services may be covered but only if it is medically necessary.
Medical Transportation – Friends & Family transportation to
and from medical
Anyone with Medicaid
Friend or family member enrolled in The Friends & Family Transportation
Call Regional Dispatch Office 24 hours before the appointment or as soon as possible after an emergency visit. See
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CoveredServices
Who isEligible
Where toAccess Services Limits
appointments Program next page for dispatch contact information.
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CoveredServices
Who isEligible
Where toAccess Services Limits
Medical Transportation –Non-Emergency transportation to
and from medical appointments
Anyone with Medicaid except some who have Medicare
Regional Dispatch OfficesAlexandria1-800-446-3490Baton Rouge1-800-259-1944Lafayette/Lake Charles1-800-864-6034Monroe1-800-259-1835New Orleans1-800-836-9587Shreveport1-800-259-7235
You should call the dispatch office 48 hours before the appointment. Same day transportation can be scheduled if absolutely necessary.The medical provider you are being transported to does not have to be a Medicaid provider but the services must be covered by Medicaid. Dispatch office will make this determination.Transportation to out-of-state appointments can be arranged but requires Prior Authorization.
Mental Health Clinic Services evaluations,
assessments, treatment, and counseling services
medication management and injections
Anyone with Medicaid
Local Office of Mental Health
Mental Health Rehabilitation assessment service planning community support medication
management individual
intervention / supportive counseling
group counseling parent / family
intervention-counseling
psychosocial skills group training
parent / family intervention - intensive
Anyone with Medicaid who meets the eligibility requirements for MHR
MHR providers
Contact Specialty Care Resource Line at 1-877-455-9955
All services must be Prior Authorized.
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CoveredServices
Who isEligible
Where toAccess Services Limits
Nurse Midwives office visits pre- & post-natal
care and delivery
Any female of child bearing age with Medicaid
Certified Nurse Midwives
Doctor
Clinic
Some limitations apply.
Nurse Practitioners & Clinical Nurse Specialists office visits
Anyone with Medicaid
Doctor
Clinic
Some limitations apply.
Prenatal Care office visits pre- & post-natal
care and delivery lab services
Any female of child bearing age with Medicaid
Doctor
Certified Nurse Midwives
Clinic
Some limitations apply.
Prescription Drugs prescription drugs
Anyone with Medicaid except those who have Medicare
Pharmacies If you are age 21 or older: co-payments are
required there is a limit of 8
prescriptions per month but your doctor can override this limit when medically necessary
Prior Authorization is required for some drug categories if the medication is not on the Preferred Drug List (PDL). The following prescription drugs are not covered: cosmetic drugs (except
Accutane) cough & cold
preparations anorexics (except
Xenical) fertility drugs when
used for fertility treatment
experimental drugs compounded
prescriptions vaccines covered in
other programs Drug Efficacy Study
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Implementation (DESI) drugs
narcotics prescribed only for narcotic addiction
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CoveredServices
Who isEligible
Where toAccess Services Limits
Podiatry Services(foot care) office visits radiology, lab and
other diagnostic tests
Anyone with Medicaid
Podiatrist Some Prior Authorization, exclusions, and restrictions apply. Podiatrist will submit Prior Authorization request.
Psychiatric Hospital Care inpatient hospital
care for illness which can only be provided in a hospital setting
basic services that a hospital provides
Anyone with Medicaid over age 22
Doctor
Hospital
Inpatient hospitalization requires Pre-certification and Length of Stay assignment. Hospital will submit Prior Certification request.
Sexually Transmitted Disease (STD) Clinics testing counseling treatment confidential HIV
testing
Anyone with Medicaid
Local Health Unit
Therapy Services occupational
therapy physical therapy speech, language
and hearing therapy
Anyone with Medicaid
Doctor
Clinic
All services must be Prior Authorized. Provider will submit the Prior Authorization request.
Tuberculosis Clinic Services treatment and
disease management services
physician visits medications
Anyone with Medicaid
Local Health Units
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Exclusion from this list may not meanthat a service is not covered.Ask your medical provider or
call Medicaid at 1-225-342-0127.
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Medicaid Purchase Plan Servicesfor persons under age 21
CoveredServices
Who isEligible
Where toAccess Services Limits
Chiropractic Services spinal
manipulation
Anyone with Medicaid under age 21
KIDMED Provider
Doctor
Clinic
Referral from a KIDMED medical screening provider or Primary Care Provider (PCP) is required.
Dental Care annual dental
screening with exam, x-rays, cleaning, topical fluoride application and oral hygiene instruction
diagnostic tests preventive services restorative services endodontic services periodontic services removable
prosthodontic maxillofacial
prosthetic oral and
maxillofacial surgery
orthodontic services adjunctive general
services
Anyone with Medicaid under age 21
Dentist Some services must be Prior Authorized. Dentist will submit Prior Authorization request.Comprehensive Orthodontic Treatment (braces) require Prior Authorization and are covered only when there is a cranio-facial deformity, such as cleft palate, cleft lip, or other medical conditions which possibly results in a handicapping malocclusion. Braces are not covered for crowded or crooked teeth, spacing problems or under/overbite.
Extended Home Health Services skilled nurse
services medically necessary
medical tasks included in plan of care
Anyone with Medicaid under age 21
Doctor You must have a letter of medical necessity and doctor’s prescription. Skilled nursing services require Prior Authorization.
Eyeglasses regular eyeglasses
when they meet a certain minimum strength requirement
medically necessary specialty eyewear and contact lenses
other services when
Anyone with Medicaid under age 21
Optometrist
Ophthalmologist
Optical Supplier
Prescriptions are required for all glasses and contacts. Specialty eyewear and contact lenses, if medically necessary, require Prior Authorization. Provider will submit Prior Authorization request.
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medically necessary
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CoveredServices
Who isEligible
Where toAccess Services Limits
Hearing Aids hearing aids any related ancillary
equipment such as earpieces, batteries, etc.
repairs, if the hearing aid was covered by Medicaid
Anyone with Medicaid under age 21
DME Provider All services must be Prior Authorized. Provider will submit Prior Authorization request
KIDMED immunizations medical, dental,
vision and hearing screenings
Anyone with Medicaid under age 21
KIDMED Provider
Doctor
ClinicPersonal Care Services basic personal care
- toileting & grooming
assistance with eating and food preparation
assistance with bladder and/or bowel requirements or problems
performance of incidental household chores for you
accompanying you to medical appointments
Anyone with Medicaid under age 21
Physician
PCA agencies
Prior Authorization is required. Agency must submit Prior Authorization request.PCS is not subject to service limits. Units approved will be based on medical necessity and the need for covered services.Personal Care Services requires a doctor’s prescription and must meet medical criteria.PCS does not cover any medical tasks such as medication administration and tube feedings.PCS must be provided by licensed provider enrolled in Medicaid to provide these services.
Psychological tests and therapy (PBS) necessary
assessments evaluations individual therapy family therapy
Anyone with Medicaid under age 21 who meets the criteria for Pervasive Developmental Disorder (PDD) or other criteria
PBS enrolled Psychologist
Contact Specialty Care Resource Line at 1-877-455-9955
MPP
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CoveredServices
Who isEligible
Where toAccess
ServicesLimits
Psychological tests and therapy (School Board) psychological
evaluation, tests, interviews, and behavioral evaluations psychological therapy, diagnosis and counseling for children and their parents
Anyone with Medicaid under age 21
EPSDT HealthServices - SchoolBoard
Substance Abuse Clinic Services individual, group
and family counseling
medical treatment medical injections psychosocial,
psychiatric, medical, and other evaluations
Anyone with Medicaid under age 21
Office of Addictive Disorders (OAD) at1-800-662-4357
Doctor
Services must be provided by the Office of Addictive Disorders.You must be diagnosed with an addictive disorder prior to receiving services.
Therapy Services (School Board) audiological
evaluation and therapy
occupational therapy, evaluation and treatment
physical therapy, evaluation and treatment
speech & language evaluation and therapy
Anyone with Medicaid under age 21
EPSDT HealthServices – School Board
Therapy Services (Other) audiological
services only in Rehabilitation Clinic and Hospital -Outpatient settings
occupational therapy
Anyone with Medicaid under age 21
Home Health provider
Hospital - Outpatient Services
Rehabilitation Clinic
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physical therapy speech & language
therapy
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Advisory Council
Medicaid Infrastructure GrantAdvisory Council
What is the Medicaid Infrastructure Grant (MIG) Advisory Council?
Louisiana's Medicaid Infrastructure Grant (MIG) Advisory Council was first established by Senate Concurrent Resolution 79 in 2001 and then reauthorized by Senate Concurrent Resolution No. 47 in 2002. The group was created to help the Department of Health and Hospitals (DHH) by:
providing advice on the medical and other service and support needs of people with disabilities who work
developing, reviewing and evaluating the Medicaid Purchase Plan assisting with outreach and education efforts for MPP and supporting Medicaid Infrastructure Grant employment initiatives
throughout the state
People with disabilities, advocates and other stakeholders from more than 25 statewide organizations and agencies serve on the council. Members include people who have Medicaid Purchase Plan coverage.
The council is supported by DHH with money it receives through the federal Medicaid Infrastructure Grant (MIG) program. MIG is a Ticket to Work initiative of the Centers for Medicare and Medicaid Services to help states develop infrastructure to support people with disabilities who work.
As part of its duties, the MIG Advisory Council recommended the creation of this guide and helped to write it. Inspiration for this book came from former member Benilda Caixeta, who died on August 29, 2005 in New Orleans.
Membership in the council is open to anyone with an interest in improving work opportunities for people with disabilities in Louisiana. For more information about the council and its work, visit www.LaMPP.org.
If you are interested in becoming a member, please contact the MIG Project Director by phone at 225-342-3159 or by email at [email protected].
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Medicaid Purchase PlanCoordinators
If you have questions, problems, or other concerns with MPP, please contact us by email at [email protected]. You may also contact directly any of our MPP Coordinators listed here.
State Office Lake Charles RegionMPP Director Celena [email protected] [email protected] 337-491-2437Paula [email protected] Alexandria Region225-342-9495 Diana DeWeese
[email protected] Orleans Region 318-487-5281Rosiland [email protected] Shreveport Region504-599-0612 Sally Maloch
[email protected] Rouge Region 318-862-9857Anastachisia McKnight [email protected] Monroe Region225-922-3006 Vickie Booker
[email protected] Region 318-251-5047Patricia [email protected] Hammond Region337-828-2611 Theresa Faulk
[email protected] Region 985-543-4311Kent [email protected]
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Medicaid Parish Offices
Acadia1113 East Northern AvenuePO Drawer 690Crowley, LA 70527Phone: 337-788-7610Fax: 337-788-7621
Allen213 B North 1st StreetPO Drawer 1170Oberlin, LA 70655Phone: 337-639-4173Fax: 337-639-4097
Ascension1532 S. Burnside Ave., Bldg. 2Gonzales, LA 70737Phone: 225-644-3700Toll Free: 888-474-2070Fax: 225-647-8743
Assumption/Lafourche1000-E Plantation RoadThibodaux, LA 70301PO Box 1038Thibodaux, LA 70302-1038Phone: 985-449-5021Toll Free: 800-401-0132Fax: 985-449-5161
Avoyelles457 West Waddil StreetMarksville, LA 71351Phone: 318-253-5946 or 318-253-5947Fax: 318-253-4060
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Beauregard1808 Highway 190 West - Suite CPO Drawer 1178DeRidder, LA 70634Phone: 337-463-9131Fax: 337-463-3929
Bienville1285 Pine Street - Suite 102Arcadia, LA 71001Phone: 318-263-9477Toll Free: 800-256-3068Fax: 318-263-2009
Bossier/Caddo/Claiborne/Webster3020 Knight StreetSuite 100Shreveport, LA 71105Phone: 318-862-9875Toll Free: 800-256-3068Fax: 318-862-9850
CaddoSee Bossier
Calcasieu/Cameron2300 Broad StreetLake Charles, LA 70601PO Box 3250Lake Charles, LA 70602-3250Phone: 337-491-2439Fax: 337-491-2785
Caldwell/Franklin/Tensas2406 West StreetPO Box 609Winnsboro, LA 71295-0609Phone: 318-435-2930Toll Free: 800-460-7726Fax: 318-435-2149
CameronSee Calcasieu
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Catahoula1305 Fourth StreetJonesville, LA 71343PO Box 886Jonesville, LA 71343-0886Phone: 318-339-4213Fax: 318-339-9969
ClaiborneSee Bossier
Concordia27797 Highway 15Ferriday, LA 71334PO Box 1724Ferriday, LA 71334-1724Phone: 318-757-3202Fax: 318-757-7455
Desoto/Natchitoches/Red River/Sabine430 Dixie PlazaNatchitoches, LA 71457Phone: 318-357-2466Toll Free: 800-873-8987Fax: 318-357-7059
East Baton Rouge2521 Wooddale BoulevardBaton Rouge, LA 70806PO Box 64808Baton Rouge, LA 70896-4808Phone: 225-922-1542Fax: 225-922-0406
East Carroll/West Carroll 702 East Jefferson St.PO Box 1006Oak Grove, La 71263-1066Phone: 318-428-2222Toll Free: 888-738-0792Fax: 318-428-1033
East Feliciana/West Feliciana12486 Feliciana Drive
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Clinton, LA 70722PO Box 165Clinton, LA 70722–0165Phone: 225-683-4757Toll Free: 800- 259-9841Fax: 225-683-9618
Evangeline1008 West LaSalle StreetVille Platte, LA 70586Phone: 337-363-4262Fax: 337-363-4251
FranklinSee Caldwell
Grant100 8th StreetPO Box 430Colfax, LA 71417-0430Phone: 318-627-5408Fax: 318-627-2985
Iberia1217 Adrian StreetNew Iberia, LA 70560PO Box 14010New Iberia, LA 70562-4010Phone: 337-373-0062Fax: 337-373-0138
Iberville/West Baton Rouge24710 Plaza Drive (70764)PO Box 269Plaquemine, LA 70765-0269Phone: 225-692-7014Toll Free: 800-631-0941Fax: 225-692-7086 or 225-692-7082
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Jackson/Lincoln1102 East Georgia, Ste. BRuston, LA 71270PO Box 1609Ruston, LA 71273Phone: 318-251-5049Toll Free: 888-436-6561Fax: 318-251-5056
Jefferson East Bank3229 36TH St. Suite 210Metairie, LA 70001PO Box 1521Metairie, LA 70004-1521Phone: 504-846-6960Fax: 504-846-6967
Jefferson West Bank/PlaqueminesHarvey State Office Building2150 West Bank Expressway, 4th FloorHarvey, LA 70058PO Box 449Gretna, LA 70054-0449Phone: 504-361-6973
Jefferson Davis437 North Market StreetPO Box 559Jennings, LA 70546-0559Phone: 337-824-2014Fax: 337-824-0842
Lafayette117 Production Dr.Lafayette, LA 70508PO Box 80708Lafayette, LA 70598-0708Phone: 337-262-1424Toll Free: 800-230-0690Fax: 337-262-1671
LafourcheSee Assumption
LaSalle
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3683 South First StreetJena, LA 71342PO Box 709Jena, LA 71342-0709Phone: 318-992-5320Fax: 318-992-5422
LincolnSee Jackson
Livingston/St. Helena29849 South Magnolia, Ste. BPO Box 457Livingston, LA 70754Phone: 225-686-2558Fax: 225-686-2820
Madison/Richland121 Ellington DriveRayville, LA 71269-0539Phone: 318-728-0344Toll Free: 800-460-7701Fax: 318-28-9348
Morehouse240 Holt StreetBastrop, LA 71220PO Drawer 1095Bastrop, LA 71221-1095Phone: 318-556-7014Fax: 318-283-0864
NatchitochesSee Desoto
Orleans/St. Bernard1010 Common St. 4th FloorNew Orleans, LA 70112PO Box 60840New Orleans, LA 70160-0840Phone: 504-599-0656Toll Free: 866-289-8303Fax: 504-599-0528
Ouachita/Union
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3100 Kilpatrick Blvd.Monroe, LA 71201PO Box 14225Monroe, LA 71207-4225Phone: 318-362-3300Toll Free: 800-510-5378Fax: 318-362-0412
PlaqueminesSee Jefferson West Bank
Pointe Coupee1919 Hospital Road, Suite BNew Roads, LA 70760PO Box 489New Roads, LA 70760-0489Phone: 225-638-6584Fax: 225-638-6586
Rapides1505 Washington St.Alexandria, LA 71301PO Box 13708Alexandria, LA 71315-3708Phone: 318-487-5670Fax: 318-487-5924
Red RiverSee Desoto
RichlandSee Madison
SabineSee Desoto
St. BernardSee Orleans
St. Charles/St. James/St. John421 West Airline Highway, Suite HLaPlace, LA 70068
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PO Box 1295LaPlace, LA 70069-1295Phone: 985-651-4809Toll Free: 800-788-4827Fax: 985-651-4818
St. HelenaSee Livingston
St. JamesSee St. Charles
St. JohnSee St. Charles
St. Landry6069 I-49 Service Road, Suite BOpelousas, LA 70570Phone: 337-942-0155Fax: 337-948-0371
St. Martin508 E. Bridge St. PO Box 319 St. Martinville, LA 70582-0319Phone: 337-394-3228Fax: 337-394-8918
St. Mary 15213 LA Highway 182 WestPO Box 1071Franklin, LA 70538-1071Phone: 337-828-2611Toll Free: 800-351-4879Fax: 337-828-2656
St. Tammany21454 Koop Dr, Suite BMandeville, LA 70471Phone: 985-871-1359Fax: 985-871-1369
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Tangipahoa121 Robin Hood DriveHammond, LA 70403Phone: 985-543-4216Fax: 985-543-4221
TensasSee Caldwell/Franklin
Terrebonne5593 Highway 311Houma, LA 70360PO Box 830Houma, LA 70361-0830Phone: 985-873-2030Toll Free: 800-723-1598Fax: 985-873-2042
UnionSee Ouachita
Vermilion1820-A Veterans Memorial DrivePO Drawer 1035Abbeville, LA 70510-1035Phone: 337-898-2854Fax: 337-898-3827
Vernon1100 Nolan TraceLeesville, LA 71446PO Box 2395Leesville, LA 71496-2395Phone: 337-238-7022Fax: 337-238-6496
Washington521 Ontario AvenueBogalusa, LA 70427Phone: 985-732-6844Fax: 985- 732-6835
Webster
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See Bossier
West Baton RougeSee Iberville
West CarrollSee East Carroll
West FelicianaSee East Feliciana
Winn207 East North St.Winnfield, LA 71483PO Box 910Winnfield, LA 71483-0910Phone: 318-648-9189Fax: 318-648-9190
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Statewide Contacts
Advocacy Center of Louisiana 800-960-7705Attention Deficit Disorder 800-233-4050Autism Society 800-955-3760Blind Services 800-737-2958Catholic Deaf Center 888-834-7955Census Bureau 800-835-9752Center for the Blind 800-234-4166Child Protection 800-422-4453Child Support Enforcement 800-256-4650Childhood Lead Poison Prevention 800-242-3112Children’s Choice Waiver 800-660-0488Children’s Welfare Program 800-259-3428Commission for the Deaf 800-256-1523Commission on Human Rights 888-248-0859Community Living Ombudsman 800-960-7705Consumer Protection 800-351-9638Department of Health & Hospitals 800-660-0488Developmental Disabilities Council 800-450-8108 Disabilities Determinations 800-578-3029Disabilities Information Access Line 800-922-3425Donated Dental Services 800-946-6016Donor Registry 800-521-4483Down Syndrome Awareness Group 225-921-5651Early STEPS (Single Point of Entry) 866-327-5978Easter Seals 800-695-7325Elderly and Disabled Adult Waiver 800-660-0488Elderly Protective Services 800-259-4990Employment Services 877-872-5627
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Epilepsy Foundation of Louisiana 800-960-0587Fair Housing Hotline 800-273-5718Families Helping Families of Louisiana 504-430-3604Family Assistance Program 888-524-3578Federation of Families 800-224-4010Food Stamps and Earned Income Tax Credit 888-524-3578Governor’s Office Disability Affairs 225-219-7500Governor’s Office Elderly Affairs 225-342-7100Head Start Program 225-342-1292Individual Development Account 225-771-5454La. Children’s Health Insurance Program (LaCHIP) 877-252-2447
La Spina Bifida Association 504-737-5181La. Work Incentive Planning and Assistance Coalition 888-942-8104Louisiana Assistive Technology Access Network 800-270-6185Louisiana Rehabilitation Services 800-737-2958LSU - Human Developmental Center 504-942-8202Meaningful Minds of Louisiana 888-886-6882Medicaid 877-252-2447Medicaid Adult Denture Service 225-342-9403Medicaid Covered Services 225-342-0127Medicaid Fraud 800-488-2917Medicaid Providers 800-259-8000Medicaid Waivers 800-660-0488
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Medicare Savings Program 888-544-7996Mental Health Advocacy Services 800-428-5432Mental Health America of Louisiana 225-201-1930NAMI of Louisiana 866-851-6264National Multiple Sclerosis Society 800-346-7323National Poison Control Center 800-222-1222New Horizons Independent Living Center 877-219-7327New Opportunities Waiver (NOW) 800-660-0488No Child Left Behind Program 877-453-2721Office for Citizens with Developmental Disabilities 225-342-0095Office for Head Start 225-219-4245Office of Addictive Disorders 225-342-9532Office of Aging and Adult Services 866-758-5035Office of Blind Services 800-737-2958Office of Charitable Gaming 800-562-9235Office of Civil Service 866-783-5462Office of Family Support 800-256-3150Office of Mental Health 225-342-2540Office of Motor Vehicles 877-368-5463Office of Public Health 800-256-4609Office of Vital Records 800-454-9570PACE Program of All-inclusive Care for Elderly 800-660-0488Partnership for RX Assistance 800-477-2669People First of Louisiana 225-383-1033Program for Children with Deaf/Blindness 877-453-2721Reg. Independent Living Research Utilization 800-949-4232Regional ADA Help 800-949-4232Relay Service (TDD) 800-846-5277Relay Service (Voice) 800-947-5277Resources for Independent Living 877-505-2260
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Salvation Army 800-725-2673School for the Deaf 225-769-8160School for the Visually Impaired 225-342-4756Senior Health Insurance Information Program 800-259-5301Small Business Assistance 800-259-2890Social Security Administration (SSA) 800-772-1213Southwest Louisiana Independent Living Center 800-403-1062Special Format Library 800-543-4702Statewide Independent Living Council 800-579-5611STEP: Strategies to Empower People 225-342-3950STOP: Solution to Poverty 225-342-9415Substance Abuse Clinics 800-662-4357Traumatic Head & Spinal Cord Injury 800-737-2958United Cerebral Palsy 504-461-4266Waiver Services (to get on the list) 877-456-1146Workers Compensation 800-209-7175
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ResourcesMPP Member Guide
KNOWING YOUR RIGHTSKNOWING YOUR RIGHTSAll workers have certain rights and responsibilities. It is against the law for businesses to discriminate against qualified individuals with disabilities.
Equal Access and Opportunity There are many laws assuring your right to equal access and opportunities to jobs. You have the right to:
Freedom from harassment Not be discriminated against Not be fired for asserting your rights Request reasonable accommodation
Reasonable Accommodation is any change or adjustment to a job, the work environment, or the way things usually are done that would allow you to apply for a job, perform job duties, or enjoy equal access to benefits. Some examples are:
Accessible workplaces, break rooms, cafeterias, and restrooms Training and written materials in accessible format Adaptive equipment including teletypewriters, readers, and software Flexible work and break schedules
You can request a reasonable accommodation at any time it is needed to help you do your job. If you are unable to perform the essential duties of your job, your employer is allowed to offer to place you in a different job. Some Health Insurance offered through employers may exclude coverage for pre-existing conditions. The company does not have to obtain additional coverage for you if it offers insurance that does not cover all of your medical expenses.
The Medicaid Purchase Plan may help to cover medical conditions or services excluded by health insurance available through your employment.Job ApplicationsBusinesses must make the job application process accessible for anyone who wishes to apply. Job applications cannot include questions about disability. You can ask for accommodations to take tests that are a required part of the application process.
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InterviewingYou must ask for any accommodation you need for an interview. Reasonable accommodation can include an accessible location for the interview, sign language interpreters, or a reader if you are blind. You should never be asked to pay for an accommodation. The business pays for the accommodation, unless it creates an undue hardship.
During an interview, potential employers may not ask questions about your disability or what type of medications you are taking. They also may not ask you to take a medical exam during or before the interview process. However, potential employers may ask about your ability to perform essential functions of the job with or without accommodations.
Receiving a Job OfferAfter you have been offered a job, you may be asked questions about your disability and asked to take a medical exam. This is legal as long as it is asked of all new employees in similar jobs. The company may not take back a job offer because a medical exam reveals a disability that does not affect your ability to do the essential functions of the job.
Affirmative ActionYour employer may ask you to voluntarily disclose if you have a disability for Affirmative Action purposes only. This is okay as long as giving the information is voluntary and will be kept confidential. Information given cannot be used against you.
Further AssistanceAdvocacy Center U.S. Department of Justice1010 Common Street, Suite 2600 Civil Rights DivisionNew Orleans, LA 70112 Disability Rights Section 800-960-7705 (Toll Free Voice & TTY) 800-514-0301 (Voice)504-522-5507 (Fax) 800-514-0383 (TTY)www.advocacyla.org/ www.usdoj.gov/Equal Employment Opportunity CommissionNew Orleans Field Office1555 Poydras Street, Suite 1900New Orleans, LA 70112 800-669-4000 (Voice)800-669-6820 (TTY)504-589-6861 (Fax)www.eeoc.gov/DisabilityInfo.govwww.disabilityinfo.govIndividual with Disabilities Education Actwww.federalresourcecenter.org/frc/idea.htmRehabilitation Act of 1973www.nationalrehab.org/website/history/act.htmlAmericans with Disabilities Act
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www.usdoj.gov/crt/ada/adahom1.htmDevelopmental Disabilities Assistance and Bill of Rights Act of 2000www.acf.hhs.gov/programs/add/ddact/DDACT2.htmlMental Health Parity Actwww.cms.hhs.gov/HealthInsReformforConsume/04_TheMentalHealthParityAct.aspHealth Insurance Portability and Accountability Actwww.hhs.gov/orc/hipaa
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Resources
LOOKING FOR A JOBLOOKING FOR A JOB
You must be employed or self-employed, either part-time or full-time, to get Medicaid Purchase Plan. If you lose your job you may be able to keep your coverage for up to 6 months, but only if you plan to go back to work. If you are not working after 6 months, your MPP coverage will stop.
The following information may help if you need to look for a new job or if you want to move into a better job.
Where can you look for a job?The internet offers many sites where you can look for jobs. These sites let you post your resume online and apply directly via email. Some sites will send you an email with new job listings that meet your needs.
Newspapers have employment sections every day, and most have a larger section on Sundays. Some also have job listings on-line.
Your local library is another place where you can get information on jobs. Libraries have newspapers and computers that you can use.
Louisiana Works Business & Career Solutions Centers provide a wide range of services:
Skills assessments Job readiness training and job matching services On-line job bank searches, resume writing, and career planning Access to computers, copiers, fax, telephone, and adaptive equipment
needed for job seeking activities On-the-job training opportunities Scholarship opportunities
All of these services are free. For more information, visit www.LAWORKS.net.
Networking is an important part of any job search. Many jobs are filled by word-of-mouth before they are advertised. Start by talking to friends, family, teachers, classmates, neighbors and other people you know. Ask them to keep you in mind if they hear of job openings. Networking can help you:
Get information about businesses and job openings Find unlisted jobs Get noticed Improve your chances of having a successful interview
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Visiting Job and Career Fairs lets you become familiar with businesses and the job market. Louisiana Job Fairs for people with disAbilities are held across the state every October. You can get information about these events at www.LaMPP.org or www.LBLN.org. Every September, you can also get information about the job fairs at 1-888-544-7996.
To prepare for a job fair: Learn about participating businesses Know your career goals Be professional in dress and attitude Bring copies of your resume’
Job InterviewsPreparing for a job interview is important. The more you know about a business and its industry, the better. Learn as much as you can about the job and prepare questions to ask during the interview.
Companies and individuals interviewing you cannot legally ask if you have a disability or ask about the nature of your disability. They can only ask if you can perform the essential duties of the job with or without reasonable accommodation. You can get more interviewing tips at janweb.icdi.wvu.edu or www.worksupport.com.
Job Search SitesState Opportunities Listing Federal Opportunities Listingwww.agency.governmentjobs.com www.usajobs.opm.govCareer Builder Disabledperson.comwww.careerbuilder.com
www.disabledperson.com/recruitability.aspDisability Jobsite JobAccesswww.disabilityjobsite.com www.jobaccess.orgJobFind Nonprofit Career Centerwww.JobFind.com www.idealist.org
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SOCIAL SECURITY WORK INCENTIVESSOCIAL SECURITY WORK INCENTIVES
If you get Social Security Disability (SSDI) there are work incentives that can help you. Some important work incentives you should know are:
Trial Work Period (TWP) allows you to test your ability to work without losing your Social Security Disability benefits.
Impairment Related Work Expenses (IRWEs) are costs that you pay for items or services related to your disability that you need to work. Examples of IRWEs include assistive technology, job coaching, attendant services, transportation, medications and medical supplies. These costs can reduce the amount of your earnings that are counted by Social Security against your SSDI benefits.
Extended Medicare Coverage allows you to keep Medicare for at least 8½ years after you go to work.
Special rules for workers who are blind or have vision impairment let you earn more money before benefits are affected. Ask for the pamphlet, If You Are Blind or Have Low Vision, from Social Security.
Expedited Reinstatement can let you get your Social Security check back if you can no longer work. You may be able to get your check for up to 6 months while Social Security decides if you should get your check back beyond the 6 months.
The work incentives listed are only some of the tools that can help you. For more information on work incentives, visit The Work Site at www.ssa.gov/work.
To make sure you are successful in your work effort, get help from a Community Work Incentive Coordinator (CWIC). A CWIC can help you with information about benefits for you and your dependents, Medicare, Medicaid, reporting your income, and anything else related to working and managing your benefits. To get more information about this assistance, call 1-888-942-8104.
Further AssistanceSocial Security Administration1-800-772-12131-800-325-0778 TTYwww.ssa.govMedicarewww.medicare.gov
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SUPPORTS TO WORKSUPPORTS TO WORK
If you need support from devices, tools, aids or from another person to help you live, work, achieve your best and participate fully in the community the following information my help.
Assistive TechnologyAssistive technology, also called AT, is a device, tool, or aid that helps you live or work. Some examples of AT are:
Braille ‘n Speak Note Taker for people with visual impairments Three-wheeled motorized scooters for people with mobility
impairments Amplified telephone receivers, flashing lights on phones and alarms
for people who are deaf or have hearing impairments Medication reminders for people with cognitive or psychiatric
disabilities
Medicaid, Medicare or Louisiana Rehabilitation Services (LRS) may be able to help you with AT costs. If you get services from any other agency or organization, you should ask if they can help you with AT.
Under the Americans with Disabilities Act (ADA) your employer may be required to help with the cost of technology that allows you to be successful on the job. Read Knowing Your RightsKnowing Your Rights to learn more about the ADA.
You can get additional information about assistive technology devices, services and funding from the Louisiana Assistive Technology Access Network (LATAN). LATAN is the state program that provides services such as:
Device demonstrations for people who want to try items before buying
The AT Marketplace, which offers access to previously-owned devices at no or low cost
Computer ReUse program AT, including durable medical equipment, available in emergencies Low interest financial loans for the purchase of AT Training and technical assistance Individual information, assistance and referrals
For more information, contact LATAN at 1-800-270-6185 or
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www.latan.org.
Personal Care AssistancePersonal care assistance provides help with daily living tasks like eating, bathing, dressing, grooming, transferring, walking, toileting and other personal needs.
If you need this kind of help, you should contact Louisiana Options in Long Term Care at 1-877-456-1146 (TDD 1-877-544-9544) about Long Term Personal Care Services (LT-PCS).
If you are eligible for services through Louisiana Rehabilitation Services (LRS) and are in need of a Personal Care Attendant (PCA), you may get help from LRS. This service can only be provided while you are participating in a plan of vocational rehabilitation services. For more information, contact Louisiana Rehabilitation Services at 1-800-737-2958 or visit www.dss.louisiana.gov.
Further Assistance with Assistive TechnologyLouisiana Medicaid1-888-544-7996www.dhh.la.gov Medicare1-800-633-4227www.medicare.govJob Accommodation Networkwww.jan.wvu.eduDisabilityinfo.govwww.disabilityinfo.govAssistivetech.netwww.assistivetech.net
Further Assistance with Personal Care ServicesDHH Office of Aging and Adult Services 1-866-758-5035www.oaas.dhh.louisiana.gov
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TAXESTAXESIn order to qualify for Medicaid Purchase Plan, your earnings must be reported to the Internal Revenue Service (IRS) or Louisiana Department of Revenue and you must pay all state, federal and payroll taxes that you owe. Depending on your income and your disability, you may not have to pay taxes, but it is important for you to file a tax return. In fact, you might even get additional cash because you file.
What you really need to know about taxes if you work People who work must file both federal and state tax returns. The Internal Revenue Service (IRS) (www.irs.gov) is the federal tax
agency. Louisiana Department of Revenue (LDR) (www.revenue.louisiana.gov/)
is the state tax agency. You may want to get help with your taxes from a professional. Call 211
to find out about free tax help in your area.
Federal Income TaxesAs a person with a disability, you may qualify for special tax deductions, income exclusions and credits.
IRS Publication 3966, Living and Working with Disabilities, provides basic tax information on deductions available for qualifying taxpayers with disabilities and for parents of children with disabilities.
You could be eligible for the Earned Income Tax Credit if your earnings are low. Even if you pay no taxes, you may get money back. Publication 596, Earned Income Credit (EITC), explains this credit.
Other helpful IRS publications include: Publication 502, Medical and Dental Expenses Publication 524, Credit for the Elderly or the Disabled Publication 907, Tax Highlights for Persons with Disabilities Publication 503, Child Dependent Tax Credit
All IRS materials are available at www.irs.gov/pub/irs-pdf/. If you have questions about these credits or benefits, call 1-800-829-1040. If you use TTY/TDD equipment, call 1-800-829-4059 to order materials and to ask tax questions.
Louisiana State TaxesIn Louisiana, there are important disability credits and exemptions that you may claim. Contact Louisiana Department of Revenue or a tax professional
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for more information about: Credit for Certain Disabilities Credit for Maintaining a Household for Certain Disabled Dependents Deduction for Adaptive Home Improvements for Disabled Individuals Disability Income Exclusion
Free Tax HelpVolunteer Income Tax Assistance (VITA) sites offer free electronic tax return preparation to people with low to moderate income. VITA sites are staffed by trained volunteers who are certified by IRS. These volunteers can answer your questions on a variety of tax subjects. Call 1-800-829-1040 for a VITA site near you or call 211 about free tax help in your area.
Items you'll need to bring with you to get this free service are: Photo identification Social Security cards for you, your spouse and dependents Birth dates for you, your spouse and dependents Wage and earning statements Interest and dividend statements from banks Copies of last year’s federal and state tax returns Bank routing and account numbers, if you want refunds deposited
directly to your account Total paid for day care Day care provider’s tax identification number List of itemized deductions Other information about your income and expenses
Louisiana Department of Revenue (LDR) offers free, secure internet filing for many taxpayers. To get more information or use this program, visit https://webtax.rev.state.la.us. LDR also hosts Super E-file Tax Day to answer questions and provide filing help for state taxes.
Contact the state or a local office of Louisiana Department of Revenue (LDR) for tax information and for the dates and locations of the Super E-file Tax Day events.
Louisiana Department of RevenuePO Box 201Baton Rouge, LA 70821 225-219-2448www.revenue.louisiana.gov/
You can also call a local LDR office at:Alexandria 318-487-5333 Baton Rouge 225-922-2300Lafayette 337-262-5455 Lake Charles 337-491-2504Monroe 318-362-3151 New Orleans 504-568-5233
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Shreveport 318-676-7505
TICKET TO WORKTICKET TO WORK
The Ticket to Work and Work Incentives Act of 1999 is a national effort to provide training, health care and other supports that some people with disabilities need to be able to work.
What is the Ticket Program?A Ticket is a voucher that lets you get employment, vocational rehabilitation and other support services from public and private providers if you get Social Security Disability (SSDI), even if you are working now.
Participation in the Ticket program is completely voluntary.
If you got a Ticket, you can take it to an Employment Network (EN), including Louisiana Rehabilitation Services (LRS), to find out about employment and education services they provide. Employment Networks are private organizations or public agencies that work with Social Security to provide services under the Ticket program. The EN or LRS will help you to design a plan to reach an employment goal. You can get a list of Employment Networks by calling Maximus at 1-866-968-7842 or by visiting the Ticket to Work website at www.yourtickettowork.com. If you use TTY/TDD equipment, call 1-866-833-2967.
What you REALLY need to know about the Ticket Maximus, your local Social Security office, or any Employment
Network can tell you if you are eligible for Ticket services. You can contact any Employment Network in your area, including
Louisiana Rehabilitation Services, to see if it has services that fit your needs.
You are free to talk with as many Employment Networks as you choose.
You can stop working with or ask to change your Employment Network at any time by contacting Maximus.
Health CareLouisiana’s Medicaid Purchase Plan is a Ticket to Work program that provides health care to you because you have a qualifying disability and you work.
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If you have Medicare, you may be able to keep it, even after you no longer get Social Security payments.
Getting HelpLouisiana Work Incentives Planning and Assistance (La-WIPA) Coalition can help if you get Social Security benefits. A Community Work Incentives Coordinator (CWIC) can explain how earnings from work affect your benefits. Contact La-WIPA at 1-888-942-8104.
The Protection & Advocacy for Beneficiaries of Social Security (PABSS) project can provide free statewide advocacy and legal help with job related issues if you get Social Security benefits.
Further AssistanceSocial Security Administration1-800-772-1213www.ssa.gov/workLouisiana Rehabilitation Services627 N. Fourth StreetP.O. Box 91297Baton Rouge, LA 70821-92971-800-737-2958225-219-4993 Faxwww.dss.louisiana.gov/departments/lrs/Advocacy Center (PABSS)1010 Common Street, Suite 2600New Orleans, LA 701121-800-960-7705 (Voice & TTY)504-522-5507 (Fax)www.advocacyla.org/
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This document can also be found at www.LaMPP.org. It was developed by Louisiana’s Medicaid Infrastructure Grant project with funds from the Center on Medicare and Medicaid Services Medicaid Infrastructure Grant CFDA 93.768. This public document was published at a total cost of $13,576.91. One thousand five hundred (1,500) copies of this public document were published in this first printing at a cost of $13,576.91. The total cost of all printings of this document including reprints is $13,576.91. This document was published by Office of State Printing P O Box 94095 Baton Rouge, LA 70804-9095 to provide information about program requirements and available supports and services for people who are enrolled in Medicaid Purchase Plan under authority of 42 CFR 435.905. This material was printed according to standards for printing by State agencies established pursuant to R.S. 43:31.