The working reference for Louisiana billing teams: who the payers are, how Healthy Louisiana's MCO structure works post-UHC exit, and the filing windows that govern your claims. Updated July 2026.
Louisiana Medicaid is administered by the Louisiana Department of Health (LDH) as "Healthy Louisiana" through managed care organizations (MCOs). The program's FFS timely filing limit is 365 days (Louisiana Administrative Code Title 50), but individual MCOs set their own limits — Healthy Blue Louisiana (Anthem/Elevance Health) requires in-network claims within 90 days under Policy G-06050 (revised June 2025). UnitedHealthcare Community Plan Louisiana exited Healthy Louisiana effective December 31, 2025 — providers with outstanding 2025 UHC Medicaid claims must submit during UHC's runout period; 2026 dates of service go to the member's new MCO assignment. The commercial market is anchored by Blue Cross and Blue Shield of Louisiana — an independent nonprofit licensee, not part of Anthem/Elevance — which is the dominant commercial carrier in the state. Vantage Health Plan serves northern Louisiana as both a Medicaid MCO and commercial carrier.
Administered by the Louisiana Department of Health (LDH). UnitedHealthcare Community Plan Louisiana exited December 31, 2025. As of January 2026, four MCOs remain active under Healthy Louisiana. Members previously enrolled with UHC have been reassigned — verify current MCO assignment via the LDH provider portal before billing. For the current MCO directory, see ldh.la.gov/healthylousiana.
| MCO | Parent / Key Notes |
|---|---|
| Healthy Blue Louisiana | Anthem/Elevance Health. In-network timely filing: 90 days (Policy G-06050, June 2025). One of the largest MCOs by membership. Use Anthem billing systems — not BCBS Louisiana |
| Aetna Better Health of Louisiana | CVS Health / Aetna. Statewide Medicaid MCO. Verify current timely filing and PA requirements in Aetna Better Health LA provider manual at aetnabetterhealth.com/louisiana |
| Molina Healthcare of Louisiana | Molina Healthcare. Statewide MCO. Absorbed members following UHC exit. Verify updated member panel. Timely filing: verify current Molina LA provider manual |
| Vantage Health Plan | Independent nonprofit, Monroe LA. Primarily northern Louisiana (Region 8). Provider-owned — distinct credentialing and billing relationship from national MCOs. Also offers commercial employer group plans in the region |
| UnitedHealthcare Community Plan LA | Exited December 31, 2025. Submit outstanding claims (DOS through 12/31/2025) to UHC during runout period. DOS on or after 1/1/2026: identify the member's new MCO via LDH portal before billing |
Louisiana Medicaid FFS allows 365 days, but Healthy Blue Louisiana requires only 90 days in-network under its June 2025 policy revision. The gap between the FFS limit and the MCO limit is the most common source of Louisiana Medicaid timely filing denials.
Verified against payer publications and LDH guidance (July 2026). Filing limits change by contract and plan year — treat this table as a starting point, not a substitute for the payer manual.
UnitedHealthcare Community Plan Louisiana did not renew its Healthy Louisiana contract and exited December 31, 2025. For claims with dates of service through 12/31/2025: submit to UHC during its runout period — do not submit to the new MCO. For dates of service on or after 1/1/2026: the former UHC Medicaid members have been reassigned to remaining Healthy Louisiana MCOs. Before submitting any claim for a patient who was previously UHC Medicaid, verify the current MCO assignment through the LDH provider portal. Submitting to the wrong MCO will result in rejection without timely filing protection.
Blue Cross and Blue Shield of Louisiana is an independent nonprofit BCBS licensee headquartered in Baton Rouge. It is not owned by or affiliated with Anthem (Elevance Health). This matters for billing teams because: (1) BCBS Louisiana and Anthem have separate payer IDs, billing addresses, and clearinghouse routing; (2) Healthy Blue Louisiana (the Medicaid MCO product) IS an Anthem product — its billing goes through Anthem's infrastructure, not BCBS Louisiana; (3) A patient with an Anthem employer plan and a BCBS Louisiana plan are billed to two entirely different entities. Verify the plan type and route accordingly.
Louisiana Medicaid FFS allows 365 days. Healthy Blue Louisiana (the Anthem Medicaid MCO, one of the largest by enrollment) requires in-network claims within 90 days under Policy G-06050 revised June 2025. The 275-day gap between the FFS limit and the Healthy Blue LA MCO limit is the single largest source of Louisiana Medicaid timely filing denials. Billing staff who rely on the state 365-day FFS limit when processing Healthy Blue LA claims will systematically miss the filing window. Maintain a separate AR workflow for Healthy Blue LA with 90-day follow-up triggers.
Vantage Health Plan is a provider-owned nonprofit headquartered in Monroe, Louisiana serving northern Louisiana parishes (Region 8: Ouachita, Bossier, Caddo, Lincoln, Union, Morehouse, and surrounding). Vantage operates both as a Healthy Louisiana Medicaid MCO and a commercial employer group health plan in the region. Northern Louisiana providers — particularly in Monroe, Shreveport, Ruston, and surrounding areas — must credential with Vantage as a primary priority alongside the national MCOs. Vantage is a fundamentally different credentialing and billing relationship from Anthem, Aetna, or Molina, with its own billing contacts, PA criteria, and provider relations team.
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