Medicaid Work Requirements

Why is Louisiana Medicaid adding work requirements?

In July 2025, Congress passed legislation that changes Medicaid rules nationwide. Beginning January 1, 2027, all states must require certain Medicaid members to meet work requirements, sometimes called community engagement activities.

What are the Medicaid work requirements?

Federal law requires that some Medicaid members take part in community engagement activities, commonly known as work requirements, to keep their Medicaid coverage. These members will need to show Medicaid they are participating in at least 80 hours of community engagement activities or earning at least $580 each month. Community engagement activities can include work, job training, education and volunteering.  A mix of approved community engagement activities can count.

When do these requirements start?

Work requirements will begin with members up for renewal and new applicants beginning January 1, 2027. Members up for renewal in January 2027 will be mailed a notice about work requirements in May 2026 and a renewal packet with work requirement materials in November 2026.

How often will the state check if a member meets the requirements?

The state will check work requirements when someone applies for Medicaid coverage and when they renew their coverage.

• For 2027 applications: Medicaid will check that qualifying activities have been completed in the month before someone applies.
• For 2027 renewals: Medicaid will check that members meet requirements for at least one month in the last six months before their renewal begins. An example: for January 2027 renewals, the period checked by Medicaid will be from May to October 2026.

What is retroactive coverage and how is it changing?

Retroactive coverage helps pay for medical bills for services received before a member officially signed up for Medicaid. Currently, Medicaid can provide retroactive coverage for members up to three months before they apply. Starting October 1, 2026:

• Most adults ages 19-64 will have one month of possible retroactive coverage eligibility.
• Children, adults ages 65 and older and people with disabilities will have up to two months of possible retroactive coverage eligibility.

Who is required to follow work requirements?

Most Medicaid members, including members who are pregnant, postpartum, parents of young children or have a disability, do not have to follow requirements. Some Medicaid members between the ages of 19 and 64 will need to follow requirements, unless they are: 

• A former foster youth under age 26
• Released from incarceration within the last 3 months
• Blind or disabled
• Medically frail (defined in the glossary)
• A veteran with a total disability rating
• Pregnant or in postpartum coverage
• Participating in substance use disorder (SUD) or alcohol treatment or rehab
• The parent or guardian of a child under age 14
• The parent, guardian, caretaker relative, or family caregiver (defined in the glossary) of a person with a disability
• Meeting Supplemental Nutrition Assistance Program (SNAP) work requirements
• Enrolled in or entitled to Medicare Part A or Part B
• Native American or Alaska Native eligible for Indian Health Service

What does medical frailty mean?

A member may be considered medically frail if they have a serious health condition that makes it hard for them to work or complete daily activities. Louisiana defines this as individuals with:

• Disabling mental disorders,
• Chronic substance use disorders,
• Serious or complex medical conditions,
• A physical, intellectual or developmental disability that significantly impairs their ability to perform one or more activities of daily living, or
• A disability determination based on Social Security criteria.

How will members know if they have to report that they meet the requirements?

Most members will not have to take further action to report that they meet requirements. Medicaid will use reliable information the state already has, like employment and social security records, to see if members meet the requirements. Medicaid estimates most of the impacted members who meet eligibility will not have to submit additional paperwork.

Medicaid will notify members who need to provide more information by mail. For 2027 renewals, LDH will send a notice six months before the renewal period begins. Example: Members up for renewal in January 2027 will get a letter in May 2026. Members who are exempt or not required to meet the rule will not receive this notice. The renewal packet will be mailed in November 2026. The renewal packet will include information on the requirements and any necessary forms to be completed.

How do members meet the requirements?

Medicaid members meet the requirements if they earn at least $580 a month or they complete at least 80 hours per month (on average) of approved activities. Approved work activities include:

• Working (including self-employment and seasonal employment)
• Participating in job training or an apprenticeship (defined in the glossary)
• Volunteering for community service (defined in the glossary)
• Going to school or participating in other education programs (at least half or part-time)

How will the state know if a member meets the requirements?

Medicaid will use reliable information the state already has, like employment and social security records, to see if members meet the requirements. Medicaid estimates this will allow the agency to confirm most of the impacted members meet eligibility without having to submit additional paperwork.

For members whose eligibility cannot be determined using data sources, a manual process will be required. Medicaid will send letters to these members when they need to take action or provide information.

How can a member prove they meet work requirements?

If Medicaid is unable to determine work requirements using available data sources, the individual will need to provide proof.

New Medicaid applicants will have to fill out a self-attestation form. By completing this form, the applicant tells Medicaid how they are meeting the requirements.

Current Medicaid members renewing their Medicaid coverage must submit a community engagement verification form. The form and instructions will be included in the member’s renewal packet. Members will need to fill in the portion of the form that applies to their specific situation. There are separate sections in the form for the different types of community engagement: working, attending school, participating in job training or volunteering. Members will need to take the form to their boss, teacher or the person in charge of where they volunteer or are attending a training program to complete. Members with pay stubs that show the number of hours worked can provide this information instead of asking their boss to complete the verification form.

How can members report proof of work requirements to Medicaid?

New applicants or current members can send proof to Medicaid:

• Online at la.gov
• By email at [email protected]
• By fax at 877-523-2987
• By mail at Louisiana Medicaid/LaCHIP, P.O. Box 91283, Baton Rouge, LA 70821-9278
• In person at a local Medicaid office (find offices at la.gov/directory

Members can also use the Eligibility Made Easy (Emmy) mobile interface to prove their work and community engagement compliance directly from their smartphones. They can use Emmy to report:

• Income and hours worked.
• Education and training program enrollment.
• Volunteering and community service activities.
• Veteran disability

When Medicaid sends a member a request for information about their income, they will also provide the member a unique link to Emmy. This link will be shared by a QR code on the member’s printed letter from Medicaid and via text message for members who have opted in to receive texts from Medicaid.

Resources for renewal, including how to upload documents online, can be found at ldh.la.gov/renew-medicaid.

How much time does a member have to complete their renewal?

Members are mailed renewal packets 60 days before their renewal date. They have 45 days to respond to show they meet the work requirements. Its important members respond during these timelines. If they do not respond, they could lose their Medicaid, even if they are still eligible.

What if I lose my Medicaid?

If you lose Medicaid solely because you did not meet the work requirements and you begin working, you may reapply after you have worked for one month in order to regain coverage.

If you lose Medicaid but believe you qualify for an exemption, or qualify for Medicaid through other means, you may file an appeal. You may also reapply if your situation changes (for example, if you are hospitalized).

If you lose Medicaid because your income is too high, you may qualify for coverage through the Health Insurance Marketplace at HealthCare.gov.

Can I appeal losing my coverage?

Yes, you have the right to appeal any Medicaid eligibility decision. The letter you get from Medicaid will explain how to file an appeal, the deadline to appeal and how to request continued benefits during the appeal process (if allowed). More information can be found at ldh.la.gov/medicaid/how-to-appeal-medicaid.

What should I do to prepare for work requirements?

Make sure your contact information is up-to-date with Louisiana Medicaid. Watch your mail for important updates from Medicaid. Follow the instructions in those letters.

Medicaid checks work requirements in the months prior to renewal, so members need to ensure they are participating in approved activities ahead of their renewal period.

How do I update my contact information with Louisiana Medicaid?

You can update your information:

• Online at la.gov
• By email at [email protected]
• By calling your health plan (contact on the back of your card at healthy.la.gov/en/compare-plans)
• By texting “INFO” to 72147
• By calling Louisiana Medicaid at 888-342-6207

Where can I find more information?

Louisiana Medicaid has created a website at ldh.la.gov/Medicaid/work-requirements with frequently asked questions about these changes.