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Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 4 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

 Online; o Applicants may complete an application using the LDH Self- Service Portal that allows the Agency to obtain an electronic signature.

 Telephone; o Applicants may complete the application by telephone with a CSU agent. A telephonic signature will be recorded and filed into the case record. o Under special circumstances, telephone applications completed by an Agency representative without CSU agent rights using a paper application require the applicant’s signature before benefits may be issued. The Agency representative shall mail the signature page to the applicant to sign.

 Mail; o Completed, signed applications are accepted by mail. An application is considered incomplete if it does not contain the applicant’s name, address, and signature. It is the Agency representative’s responsibility to obtain any necessary information on incomplete applications. Note: A typed name in the signature line of a paper application is not an acceptable signature.

 In person; or

 Through other commonly available electronic means.

It is an agency requirement that the applicant sign an initial application under the penalty of perjury. The agency must accept electronic, including telephonically recorded signatures and handwritten signatures submitted via any other electronic transmissions available.

The agency does not require a separate application for Medicaid from an individual automatically entitled to Medicaid following a determination of eligibility by another agency.

The Medicaid application form: