Page 6

Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 6 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

else:  The applicant,  An adult who is in an applicant's MAGI household (tax filer or non- tax filer),  An adult who is in the applicant’s family, [taxpayer and anyone claimed as tax dependent],  An Authorized Representative (R-0000): o Parent living with a minor child; o Legal Spouse; o Legal Guardian, curator, or tutor; o Power of attorney; o Representative for Minor SSI Recipient; or o A person designated by applicant to be an Authorized Representative.  Someone acting responsibly for the applicant who is deceased, a minor or incapacitated per court order. Age and letters from doctors are not evidence of incapacity; Note: A minor may apply for assistance without the consent of the parent or legal guardian with whom they reside.

 The appropriate Office of Juvenile Justice (OJJ) worker for a child in the custody of the state; or  Other authorized agencies.

G-700 APPLICATION DATE The application date is the date the signed application is received by the Agency, the Federally Funded Marketplace (FFM), an application assistor, or a certified Medicaid application center (AC). This applies to applications taken by telephone or received in-person, mail, fax, or electronically. Medicaid is responsible for processing all application requests and facilitating the completion of the application.

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Page 6

Official source

Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 6 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

else:  The applicant,  An adult who is in an applicant's MAGI household (tax filer or non- tax filer),  An adult who is in the applicant’s family, [taxpayer and anyone claimed as tax dependent],  An Authorized Representative (R-0000): o Parent living with a minor child; o Legal Spouse; o Legal Guardian, curator, or tutor; o Power of attorney; o Representative for Minor SSI Recipient; or o A person designated by applicant to be an Authorized Representative.  Someone acting responsibly for the applicant who is deceased, a minor or incapacitated per court order. Age and letters from doctors are not evidence of incapacity; Note: A minor may apply for assistance without the consent of the parent or legal guardian with whom they reside.

 The appropriate Office of Juvenile Justice (OJJ) worker for a child in the custody of the state; or  Other authorized agencies.

G-700 APPLICATION DATE The application date is the date the signed application is received by the Agency, the Federally Funded Marketplace (FFM), an application assistor, or a certified Medicaid application center (AC). This applies to applications taken by telephone or received in-person, mail, fax, or electronically. Medicaid is responsible for processing all application requests and facilitating the completion of the application.