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Louisiana Medicaid Eligibility Manual Application Processing

Issued January 7, 2026 Replaced July 16, 2024 Page 5 of G-0000 Revised/added text indicated by underscore Deleted text indicated by “**”

 Is the official agency document used to collect information about the applicant(s) necessary to determine eligibility;  Is the applicant's formal declaration of financial and other circumstances at the time of application;  Is the applicant's formal declaration that all information provided is true and correct under the penalty of perjury;  Provides notice of the applicant’s rights and responsibilities  Shall not be altered after the applicant has signed the form; and  May be used in a court of law.

G-400 TIME LIMITS FOR DISPOSITION OF APPLICATIONS Time limits for disposition of applications cover the period from the date of application to the date the agency notifies the applicant of its decision.

Ninety (90) days are allowed for the disposition of applications requesting coverage on the basis of disability, which requires a determination, by the Medical Eligibility Determination Team (MEDT).

Fortyfive- (45) days are allowed for disposition of all other applications.

For individuals who have applied for LTC Prior to placement in a facility or HCBS and have not received a waiver offer, allow the application to remain pending up to forty-five (45) days. If the applicant is requesting LTC coverage, but has not entered the facility by the 45th day, deny eligibility for LTC and consider eligibility in other programs.

G-500 RESERVED

G-510 RESERVED

G-600 WHO MAY APPLY FOR ASSISTANCE An individual may apply for medical assistance without delay and may apply for any program they choose.

The following individuals may apply for assistance on behalf of someone