Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued March 4, 2026

Page 2 of H-100 Replacing January 6, 2026 Revised/added text indicated by underscore

Deleted text indicated by “**” o Family Opportunity Act Medicaid Buy-In Program (FOA), for children with disabilities and family gross income at or below 300 percent of the Federal Poverty Limit (FPL). Refer to H-2300 Family Opportunity Act Medicaid Buy-in Program; o Qualified Medicare Beneficiary (QMB), for all applicants or enrollees who are entitled to or enrolled in Medicare Part A. Consider QMB Plus eligibility before considering eligibility for QMB Only. Refer to H-1100 Qualified Medicare Beneficiary (QMB); o Specified Low-Income Medicare Beneficiary (SLMB), for all applicants/enrollees who are entitled to or enrolled in Medicare Part A. Consider SLMB Plus eligibility before considering eligibility for SLMB Only. Refer to H-1300 Specified Low-Income Medicare Beneficiary; o Qualified Individuals (QI), for all applicants/enrollees who are entitled to or enrolled in Medicare Part A. Refer to H- 2000 Qualified Individuals (QI); o Qualified Disabled and Working Individual (QDWI). Refer to H-1200 Qualified Disabled and Working Individuals (QDWI); and o Extended Medicaid (Disabled Adult Children (DAC), Disabled Widows/Widowers (DW/W), Early Widows/Widowers (EW/W), Pickle, and Disabled Widows/Widowers/Divorced Spouses with no Substantial Gainful Activity (SGA Disabled W/W/DS)), for every former SSI beneficiary who applies for Medicaid. Refer to H-600 Extended Medicaid. o Medicaid Purchase Plan, for people with disabilities who work. Refer to H-2100 Medicaid Purchase Plan (MPP). o Act 421 Children’s Medicaid Option (TEFRA) for children with disabilities who live in the community and who meet level of care provided in an institution. Refer to H-3800 Act 421 - Children's Medicaid Option (TEFRA). o Eligibility for long term care (LTC) for applicants in or who will enter a LTC facility (refer to H-800 Long Term Care), or who have been offered an opportunity for home and