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Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 27 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

Spend-Down Medically Needy Program (SD-MNP) The BHSF Form 1-A used in making a determination for SD-MNP is valid for up to twelve (12) months from the date of application as long as there is no break in quarters of coverage. Refer to H-1011 MNP Groups for more information on SD-MNP. Re-using the Renewal Form For individuals whose eligibility was terminated at renewal for failure to return the renewal form or needed documentation, the agency must reconsider eligibility without requiring a new application if the renewal form and/or requested information is returned within 90 calendar days after the date of termination.

The renewal form returned within the reconsideration period serves as an application, which means the agency must make a determination consistent with application timeliness standards.

The effective date of coverage for individuals found eligible for Medicaid will be the 1st day of the month the renewal was returned. Up to 3 months of retroactive coverage is available if the individual received Medicaid services following their termination and meet the Medicaid eligibility requirements when services were received.

G-1800 RESERVED

G–1900 REFERRALS TO SSI An application for SSI is not a requirement for eligibility in any Medicaid Program.

If the applicant/beneficiary applies for SSI, the Agency will be notified by SDX of SSI certification or denial. Scenarios for general Medicaid applications See Z-400 Federal Benefit Rate for FBR amounts

Individuals with/without spouse Income and resources below FBR. Referral for SSI is required.