Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued March 4, 2026

Page 3 of H-100 Replacing January 6, 2026 Revised/added text indicated by underscore

Deleted text indicated by “**” community based services (HCBS). Refer to H-900 Home and Community Based Services (HCBS). o Spend-Down Medically Needy Program (SD-MNP) eligibility for applicants denied Medicaid because of income. Refer to H-1000 Medically Needy Program – General Information. See also H-110 Roll-down for MAGI-related Assistance. o Acute Care Hospital (ACH) eligibility for individuals institutionalized in an Acute Care Hospital for at least 30 consecutive days. Refer to H-850 Long Term Care Note: An institutionalized individual with a community spouse and resources that exceed the allowable limits for another Medicaid program may be eligible using spousal impoverishment resource provisions. Refer to I-1660 Spousal Impoverishment Resource Provisions (LTC/HCBS).

An applicant has the right to apply for Medicaid in any program. If the applicant/enrollee insists on including persons in a program for which they are obviously ineligible, complete the eligibility process and certify only eligible individuals. Notify the applicant of the individuals found ineligible.

Once a program has been selected, determine eligibility in accordance with policy for that program. H-100.2 Evaluation of Eligibility in Other Programs

Eligibility in other assistance programs must be considered and the applicant/enrollee must be advised of other programs for which he may be eligible if: • At any point during the application process an applicant is determined ineligible; • At any point after certification an enrollee is determined ineligible; or • A new member enters the household. SD-MNP eligibility must be considered if the applicant/enrollee is income ineligible for all programs.