Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determination Responsibility

Reissued July 27, 2023

Page 2 of F-0000 Replacing June 07, 2022

Revised/added text indicated by underscore

Deleted text indicated by “**” • LaCHIP • LaCHIP Affordable Plan • LaCHIP Phase IV - Prenatal Care • Long Term Care • Long Term Care Spend-Down • Medicaid Purchase Plan • Parents and Caretaker Relatives • Pregnant Women • Provisional Medicaid • Qualified Disabled Working Individuals • Qualified Individuals • Qualified Medicare Beneficiaries • Refugee Medical Assistance • Regular Medically Needy • Specified Low-Income Medicare Beneficiary • Spend-Down Medically Needy • Take Charge Plus • Tuberculosis Infected Individuals • Youth Aging Out of Foster Care

F-100.1 MANDATORY COVERAGE GROUPS

• Children with Adoption Assistance, Foster Care, or Guardianship Care Under Title IV-E • Continued Medicaid • Deemed Newborn Children • Disabled Adult Children (DAC) • Disabled Widows and Widowers (DW/W) • Disabled Widows/Widowers and Disabled Surviving Divorced Spouses Unable to Perform Substantial Gainful Activity (SGA