Does Medicaid Cover Pediatric Care in Baton Rouge? A Parent’s Guide
Does Medicaid Cover Pediatric Care in Baton Rouge? A Parent’s Guide
Key Takeaways
- Yes. Louisiana Medicaid covers most pediatric care for children, including checkups, vaccines, sick visits, and care for conditions like asthma and ADHD.
- Checkups are covered through EPSDT, a Medicaid benefit for children and young adults under 21.
- Most covered visits cost families nothing. Children on Medicaid generally have no copay for doctor visits.
- Cosmetic services like ear piercing are not covered.
- Red Stick Pediatrics in Baton Rouge accepts Louisiana Medicaid and is accepting new patients. Call (225) 273-5995.
If your child has Medicaid, you may wonder what’s covered and which doctors will see you. The short answer is good news. Louisiana Medicaid covers almost everything your child needs from a pediatrician. That includes the yearly checkups that keep kids healthy and the sick visits you didn’t plan for.
This guide explains what’s covered, what isn’t, and how to find a Baton Rouge pediatrician who accepts Medicaid.
What Is Louisiana Medicaid for Kids?
Louisiana Medicaid is free or low-cost health coverage for children in eligible families. It is run by the Louisiana Department of Health (LDH). Most children on Medicaid in Louisiana get their benefits through a Healthy Louisiana health plan.
Children may be covered through:
- Medicaid, for children in families with limited income
- LaCHIP (Louisiana Children’s Health Insurance Program), for children in families who earn too much for regular Medicaid but can’t afford private insurance
For your pediatrician visits, both work much the same way. You show your child’s card at check-in, and the visit is billed to your plan.
Healthy Louisiana Health Plans
When your child joins Medicaid, they’re enrolled in one of these plans:
- Aetna Better Health of Louisiana
- AmeriHealth Caritas Louisiana
- Healthy Blue
- Humana Healthy Horizons in Louisiana
- Louisiana Healthcare Connections
- UnitedHealthcare Community Plan
Red Stick Pediatrics accepts: . Not sure which plan you have? Look at the front of your child’s card, or call us at (225) 273-5995.
What Pediatric Care Does Louisiana Medicaid Cover?
Here’s a quick look at common pediatric services and whether Medicaid covers them.
| Service | Covered by Louisiana Medicaid? | Notes |
|---|---|---|
| Well-child checkups | ✅ Yes | Covered under EPSDT on the AAP schedule |
| Vaccines (immunizations) | ✅ Yes | Vaccines provided at no cost through the Vaccines for Children program |
| Sick visits | ✅ Yes | Fever, ear infections, strep, rashes, and more |
| Newborn care | ✅ Yes | Starting with the first visit, 3–5 days after birth |
| Vision and hearing screenings | ✅ Yes | Part of well-child visits |
| Developmental and autism screenings | ✅ Yes | At recommended ages |
| Lead screening | ✅ Yes | Required at 12 and 24 months for children on Medicaid |
| ADHD evaluation and follow-up | ✅ Yes | Including medicine management |
| Asthma and allergy care | ✅ Yes | Including inhalers and spacers with a prescription |
| Teen (adolescent) care | ✅ Yes | Including confidential care for teens |
| School and sports physicals | ✅ Usually | Covered when done as the child’s yearly well-child visit |
| Specialist visits | ✅ Yes | May need a referral from your child’s pediatrician |
| Rides to medical appointments | ✅ Yes | Non-emergency transportation through your health plan |
| Ear piercing | ❌ No | Cosmetic. Self-pay at Red Stick Pediatrics ($50 first pair) |
Coverage can vary by plan. When in doubt, call your plan’s member services number or ask our front desk.
What Is EPSDT? (The Checkup Benefit Every Parent Should Know)
EPSDT stands for Early and Periodic Screening, Diagnostic, and Treatment. It is a federal Medicaid benefit for children and young adults under age 21. EPSDT is the reason Medicaid covers your child’s checkups so completely.
Under EPSDT, your child’s well-child visits include:
- Physical exam and growth check (height, weight, head size for babies)
- Developmental screening: speech, movement, learning, and behavior
- Vision and hearing tests
- Vaccines that are due
- Lab tests when needed, like lead and anemia screening
- Health guidance for parents on nutrition, sleep, and safety
- Referrals and treatment for anything found during the visit
EPSDT also requires Medicaid to cover medically necessary treatment found during a screening, even for services not normally covered for adults.
How Often Should My Child Have a Checkup?
The American Academy of Pediatrics (AAP) recommends well-child visits at:
- Babies: 3–5 days, 1 month, 2, 4, 6, 9, and 12 months
- Toddlers: 15, 18, 24, and 30 months
- Age 3 and up: once every year
Medicaid covers every one of these visits. Missed a few? That’s okay. Call us and we’ll help your child catch up.
Does My Child Have to Pay a Copay?
In most cases, no. Federal Medicaid rules protect most children from copays and out-of-pocket costs for covered services. Well-child visits, vaccines, and sick visits at a pediatrician’s office usually cost families nothing.
You may have a cost for:
- Services Medicaid doesn’t cover, like ear piercing
- Visits to a provider outside your plan’s network, without approval
That’s why it’s worth confirming your plan is accepted before your first visit.
Can Medicaid Help Get My Child to Appointments?
Yes. Louisiana Medicaid covers non-emergency medical transportation (NEMT). That means free rides to covered medical appointments for members who don’t have another way to get there.
To schedule a ride:
- Call the member services number on the back of your child’s Medicaid card
- Ask for non-emergency transportation
- Book at least 48 hours ahead when possible
[VERIFY]
Families from Baker, Zachary, Central, Denham Springs, Prairieville, and Gonzales often use this benefit to reach our clinic on Tara Blvd.
How Do I Choose or Change My Child’s Pediatrician on Medicaid?
With Healthy Louisiana, each child is assigned a primary care provider (PCP), usually a pediatrician. You have the right to choose your child’s PCP, and you can change it.
To make Red Stick Pediatrics your child’s pediatrician:
- Call us at (225) 273-5995 to confirm we accept your child’s plan
- Call your health plan’s member services (number on the back of the card) and ask to change your child’s PCP to Red Stick Pediatrics
- Schedule your first visit and bring your child’s card, your photo ID, and shot records
Many plans also let you change your PCP through their website or app. Our front desk is happy to walk you through it.
How Do I Apply for Medicaid or LaCHIP in Louisiana?
If your child doesn’t have coverage yet, you can apply:
- Online: through the Louisiana Department of Health at ldh.la.gov
- By phone: Louisiana Medicaid customer service, 1-888-342-6207
[VERIFY] - In person: at a Medicaid application center or partner office in East Baton Rouge Parish
Pregnant? You can apply for your baby’s coverage before birth. Newborns born to mothers on Medicaid are typically covered from birth. Choose your baby’s pediatrician early so the first visit is already arranged.
Finding a Pediatrician That Accepts Medicaid in Baton Rouge
Not every clinic makes Medicaid families feel welcome. When you call a pediatric office, ask:
- “Do you accept my child’s Healthy Louisiana plan?”
- “Are you accepting new Medicaid patients?”
- “Do you offer same-day sick visits?”
- “Are you open on Saturdays?”
At Red Stick Pediatrics, the answer to all four is yes. We’ve cared for Baton Rouge children since 2007, and Medicaid families are the heart of our practice. Your child gets the same expert care every patient receives. Learn more about our clinic →
We offer:
- Well-child visits on the AAP schedule
- Same-day sick visits
- Newborn care and immunizations
- ADHD & behavioral care
- School & sports physicals
See all of our pediatric services →
Frequently Asked Questions
Does Medicaid cover well-child visits in Louisiana?
Yes. Louisiana Medicaid covers all recommended well-child visits for children under 21 through the EPSDT benefit.
- Includes exams, growth checks, screenings, and vaccines
- Follows the AAP schedule: 7 visits in the first year, then regularly through the teen years
- Usually no copay
Does Medicaid cover vaccines for kids?
Yes. Children on Louisiana Medicaid get all recommended vaccines at no cost.
- Vaccines come through the federal Vaccines for Children (VFC) program
- Includes vaccines required for school and daycare
- Red Stick Pediatrics keeps your child’s shot record up to date
Does Medicaid cover sports physicals in Louisiana?
Usually yes, when the sports physical is done as part of your child’s yearly well-child visit.
- Bring the school or league form to the visit
- A separate, stand-alone sports physical may not be covered
- Schedule before July to avoid the back-to-school rush
Does Medicaid cover ear piercing?
No. Ear piercing is cosmetic, so Medicaid does not cover it.
- Red Stick Pediatrics offers sterile ear piercing for kids 9 months and older
- $50 first pair · $25 each additional pair
[confirm]
Can I switch pediatricians if my child has Medicaid?
Yes. Louisiana Medicaid families can choose and change their child’s primary care provider.
- Call your health plan’s member services number
- Ask to change your child’s PCP to the new pediatrician
- Confirm the new office accepts your plan first
Does Red Stick Pediatrics accept Medicaid?
Yes. Red Stick Pediatrics at 888 Tara Blvd in Baton Rouge accepts Louisiana Medicaid and LaCHIP, and is accepting new patients.
- Call (225) 273-5995
- Open Mon–Fri 8 AM–5 PM and Saturday mornings
What should I bring to my child’s first Medicaid visit?
Bring your child’s Medicaid card, your photo ID, and any shot records you have.
- Medicine list and past medical records, if available
- Custody or guardianship papers, if you’re not the parent
- A list of your questions
The Bottom Line
If your child has Louisiana Medicaid, their pediatric care is covered. Checkups, vaccines, sick visits, and care for ongoing conditions usually come at no cost. The most important step is finding a pediatrician who accepts your plan and makes your family feel welcome.
Red Stick Pediatrics is that place for Baton Rouge families. We’re accepting new patients, including Medicaid.
📞 Call (225) 273-5995
This article is for general information and isn’t a substitute for medical or insurance advice. Coverage details can change. Confirm your benefits with your Healthy Louisiana plan.
