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Louisiana Medicaid Eligibility Manual Application Processing

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

G-800 ACCEPTING APPLICATIONS The agency shall require a written application, signed under penalty of perjury, on a form issued by the Agency. Electronic, including telephonically recorded, signatures and handwritten signatures transmitted via any other electronic transmission must be accepted. The Agency must accept an application and any documentation required from:  The applicant,  An adult who is 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. An application will be accepted:  Via the LDH Self-Service portal;  By telephone;  By mail;  In-person;  Via the Federal Funded Marketplace (FFM);  From a certified application center; or  Through other commonly available electronic means (scanning, imaging, email and facsimile). Requirements to safeguard applicant