Louisiana Medicaid and LaCHIP for a Child Living with a Grandparent

You Do Not Need Custody to Get Health Coverage

This is the single most important thing grandparents raising grandchildren in Louisiana need to hear about health coverage: you do not need a court order, a Provisional Custody by Mandate, or any formal legal document to enroll a child in Medicaid or LaCHIP. Informal care — the child simply lives with you — is enough to apply.

That makes health coverage the first thing to secure. While you sort out custody paperwork for KCSP or navigate the FITAP application, the child can already have full medical, dental, vision, and behavioral health coverage at no cost.

Income Rules for a Child in Kinship Care

Louisiana Medicaid and LaCHIP use Modified Adjusted Gross Income (MAGI) rules. How those rules apply depends on whether you claim the grandchild as a tax dependent:

If you do not claim the child on your taxes (or you do not file taxes), the child is evaluated as a separate tax household. Only the child's own income counts — which for most grandchildren in kinship care is $0. A child with no income qualifies automatically under the income test.

If you do claim the child as a tax dependent, the child joins your tax household and your income is counted. Even then, the income thresholds are generous:

• LaCHIP Standard: covers children up to age 19 with household income up to 217% FPL — no monthly premium
• LaCHIP Affordable Plan: covers children with household income between 218% and 255% FPL — a low monthly premium on a sliding scale

For most kinship households, especially those where the grandparent does not claim the child on taxes, the child qualifies for free coverage.

What LaCHIP Covers

LaCHIP provides comprehensive coverage:

• Doctor visits and specialist referrals
• Hospitalization and emergency room care
• Dental care (including orthodontics when medically necessary)
• Vision exams and glasses
• Prescriptions
• Behavioral health and counseling
• Immunizations and well-child checkups

Once enrolled, the child has 12 months of continuous eligibility. Minor income fluctuations during that year will not disrupt coverage.

The Caregiver's Own Health Coverage

If your own income falls below 138% of the federal poverty level, you may qualify for Louisiana Medicaid through the ACA adult expansion — full physical and behavioral healthcare at no cost.

Starting January 1, 2027, the One Big Beautiful Bill Act introduces community engagement requirements for non-exempt ACA expansion adults. But relative caregivers are protected by three exemptions: caring for a child under 14, caring for a person with a disability, or being aged 55 or older. Most kinship grandparents meet at least one.

How to Apply

Apply through the CAFÉ portal at cafe.dcfs.la.gov or call 1-888-342-6207. You will need the child's birth certificate, Social Security card, and any income documentation (if the child has income). Processing takes up to 45 calendar days.

If the child needs medical care before the application is processed, take them to a Federally Qualified Health Center (FQHC) — these accept patients regardless of insurance status and can help with the Medicaid application on-site.

The Louisiana Kinship Financial Help guide walks through health coverage alongside cash assistance, food programs, and childcare subsidies — everything organized in one document so you are not piecing together information from five different agency websites.

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