Act 421 Children's Medicaid Option (421-CMO)

Not sure if you qualify? Apply to find out.

IMPORTANT:

• If you do not choose a health plan, one will be chosen for you. Visit Choose a Plan for more information about selecting a plan.
• When applying online, make sure you:
  • Check the box showing the child has a disability on the Additional Personal Details screen:
    
    
  • Select the child and choose “Disabled” from the list:
    
• If you apply using a paper application, answer “yes” to the disability question (as shown in question 12 below) so your application is reviewed for Act 421-CMO: 
  

Your local Human Services District will review your child’s needs to see if they meet the required level of care. 

You will receive a packet with forms to complete and return. It is very important to: 

• Fill out all forms completely
• Include any requested medical records
• Send everything back on time

If the forms are missing or incomplete, your application may be denied.

The packet may include:

• A cover letter with instructions
• A form allowing Medicaid to request medical information, if needed
• Medical review forms completed by your child's doctor

You can submit the completed packet by:

• Fax to: 1(225) 389-8019
• Email to [email protected]
• Mail:
  Medicaid Application Office
  6069 I-49 Service Road
  Ste B
  Opelousas, LA 70570
• Online (Instructions here)

If your child meets the level of care requirement, you move to Step 3.

Your child must meet the Social Security Administration’s definition of disability. 

If Social Security has not already made a disability decision, Medicaid will request one. You may be asked to provide more medical information. 

If your child is approved, you move to Step 4. 

If your child meets the medical and financial requirements, they will receive Medicaid through a Healthy Louisiana health plan. 

When applying, you may choose a health and dental plan. If you do not choose one, a plan will be selected automatically.