Page 1

Louisiana Medicaid Eligibility Manual Category

Issued June 28, 2017

Page 1 of E-0000 Revised/added text indicated by underscore

Deleted text indicated by “**” E-0000 CATEGORY E-100 GENERAL INFORMATION

Eligibility for the Medicaid and Children’s Health Insurance Program (CHIP) is limited to certain groups of individuals authorized by Congress. When authorizing a group, Congress also establishes specific requirement(s) which must be met to qualify as a member of that group.

Each designated group is assigned a category of assistance. The requirement(s) which must be met to fit into that group or category is known as the categorical requirement(s).

E-200 CATEGORIES OF ASSISTANCE FOR WHICH BHSF DETERMINES MEDICAID ELIGIBILITY

The Patient Protection and Affordable Care Act, collectively referred to as the Affordable Care Act of 2010 (ACA), was enacted on March 23, 2010. Effective January 1, 2014, the ACA required states to adopt a new methodology for determining eligibility for Medicaid, which is based on Modified Adjusted Gross Income (MAGI).

As a result of ACA, programs are grouped by those that use MAGI methodology and those that do not (non-MAGI). **

MAGI Eligibility Groups  Adults ages 19 through 64  Pregnant Women  Infants and Children under age 19  Parent or other caretaker relative with a dependent child  Former foster care  Medically Needy  Transitional Medical Assistance  Tuberculosis Infected  Breast or Cervical Cancer  Family Planning Services

Non-MAGI Eligibility Groups  Aged, Blind and Disabled  Qualified Disabled and Working Individuals