Louisiana children whose families sign up for the expanded Louisiana Children's Health Insurance Program - known as the LaCHIP Affordable Plan - can now access the same statewide network of doctors, hospitals and other medical providers available to state employees enrolled in the state Office of Group Benefits' PPO health plan.
The LaCHIP Affordable Plan utilizes an innovative partnership between the Louisiana Department of Health and Hospitals and OGB to deliver health benefits to Louisiana children under age 19 in families with annual incomes between 200 and 250 percent of the federal poverty level.
Benefits for children enrolled in the LaCHIP Affordable Plan are tied to OGB's familiar PPO plan of benefits. One key difference is no deductible for most medical benefits. The majority of participants receive Level 1 benefits with typical PPO co-payments, but some are initially eligible for Level 0 benefits with no co-pays.
All participants are eligible for Level 0 benefits once they have paid out-of-pocket expenses totaling five percent of the family's income. Once this level is reached, the family pays no premiums or co-payments for the remainder of the plan year, which runs from July 1 through December 31.
The LaCHIP Affordable Plan is designed to simplify administration for OGB and the agency's provider partners. Enrollees are mailed LaCHIP Affordable Plan ID cards to present to providers and pharmacies. Provider reimbursement is the same as OGB's PPO contracts and providers can access claim, eligibility and benefit information exactly as they do for PPO members. OGB's provider help line, Rightfax and website functions support inquiries on LaCHIP Affordable Plan issues as well as PPO plan questions.