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Louisiana Medicaid: Medical coverage

We can help you achieve your best health. Learn about your medical coverage. Also learn how to find doctors and other healthcare providers.

Helping you stay healthy is important to us

We cover all medically necessary Medicaid-covered services for our Humana Healthy Horizons® in Louisiana members, including services that:

  • Meet your medical needs as ordered by your healthcare provider
  • Help you achieve age-appropriate growth and development
  • Help you attain, maintain, or regain functional capacity

See your Member Handbook for a full list of your coverage and benefits

Covered services

Humana Healthy Horizons in Louisiana members get all medically necessary Medicaid-covered services at no cost. See your Member Handbook for information about:

  • When prior authorization (preapproval) is needed
  • When a referral is needed
  • Service definitions
  • If the service has eligibility requirements (e.g., some services may be available only to members under age 21, etc.)

Covered medical services include:

Physical health services

  • Allergy testing and allergen immunotherapy
  • Ambulatory surgical services
  • Anesthesia
  • Applied behavior analysis therapy (ages 0–20)
  • Audiology services
  • Bariatric surgery
  • Breast surgery
  • Chiropractic services (ages 0–20)
  • Cochlear implant (ages 0–20)
  • Diabetes self-management training
  • Durable medical equipment, prosthetics, orthotics, and certain supplies
  • Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services (ages 0–20)
  • Emergency services
  • End-stage kidney disease services
  • Eye care and vision services
  • Family-planning services
  • Federally Qualified Health Center (FQHC)/Rural Health Clinic (RHC) services
  • Genetic testing
  • Glasses, contacts, and eyewear
  • Gynecology
  • Home health-extended services (ages 0–20)
  • Home health services
  • Hospice services
  • Hospital services
  • Inpatient hospital services
  • Outpatient hospital services
  • Hyperbaric oxygen therapy
  • Immunizations
  • Intrathecal baclofen therapy
  • Laboratory and radiology services
  • Limited abortion services
  • Medical transportation services
  • Newborn care and discharge
  • Obstetrics
  • Pediatric day healthcare services (ages 0–20)
  • Personal care services (ages 0–20)
  • Pharmacy services
  • Physician-administered medication*
  • Physician/professional services
  • Podiatry services
  • Preventive services for adults (ages 21 and older)
  • Sterilization
  • Telemedicine/telehealth
  • Therapy services
  • Tobacco cessation services
  • Vagus nerve stimulators

We will not pay for services or supplies you receive that Medicaid does not cover, including:

  • Any service (drug, device, procedure, or equipment) that is not medically necessary
  • Experimental/investigational drugs, devices, procedures, or equipment, unless approved by the secretary of the Louisiana Department of Health
  • Cosmetic drugs, devices, procedures, or equipment
  • Assistive reproductive technology for treatment of infertility
  • Elective abortions (those not covered in the Louisiana Medicaid State Plan) and related services
  • Surgical procedures discontinued before completion
  • Harvesting of organs when a Louisiana Medicaid member is the donor of an organ to a non-Medicaid member
  • Provider-preventable conditions

Out-of-state medical care

We will cover medically necessary services you need outside of Louisiana when you meet any of the following conditions:

  • Medical services are needed because of a medical emergency
  • Medical services are needed and your health would be endangered if you were required to travel to Louisiana
  • We determine, on the basis of medical advice, that the needed medical services, or necessary supplementary resources, are more readily available in the other state
  • It is general practice for members in a particular locality to use medical resources in another state

Prior authorization

You may need approval before getting some services. This preapproval is called prior authorization.

To learn more about prior authorization:

  • Refer to your Member Handbook
  • Call Member Services at 1-800-448-3810 (TTY: 711), Monday – Friday, 7 a.m. – 7 p.m.

You, your authorized representative, or a provider can submit a prior authorization request on your behalf.

Find a doctor

Where should you go to see a doctor? You have choices.

Learn where to get care depending on the care you need.

To find a doctor, specialist, hospital, healthcare facility, or other type of in-network service provider:

Watch a short video about using our Find a Doctor service

To use our online Find a Doctor tool go to Humana.com/FindaDoctor.

Enter your ZIP code, select Medicaid as your coverage type, and select Network from the drop-down menu.

You can then search by the name of the doctor or facility, specialty, such as cardiology, or a condition such as ear infection.

You also can choose All and type any text into the search.

Then click Search.

Click Update my search to search for something else.

If you need help finding and choosing a doctor, call the number on the back of your enrollee ID card to speak with an Enrollee Services representative.

  • Call Member Services at 1-800-448-3810 (TTY: 711), Monday – Friday, 7 a.m. – 7 p.m.

Looking for help?

Contact us

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Use this Find a Dental Provider service to find a dentist near you.