Page 7

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued March 4, 2026

Page 7 of H-100 Replacing January 6, 2026 Revised/added text indicated by underscore

Deleted text indicated by “**” H-110.4 Roll-Down Flowchart For MAGI-Related Rejections, Closures, Or Removal Of Ineligible Enrollees

MAGI Groups (non-aged, blind, disabled) Non-disabled Adults Children under age 19 Pregnant women PCR Income to 24% FPL Former Foster Care (age 18 to 26; no income test; If eligible for both FFC and AG programs, enroll the individual in FFC.) Loses PCR/FITAP coverage due to increased income Transitional Medicaid (up to 1 year additional coverage) Adult Group Income to 138 % FPL (no Medicare coverage)

CHAMP Income to 147% FPL LaCHIP Income 148% to 255% FPL

CHAMP Income to 147% FPL Medicaid Citizens & Legal Immigrants Income to 138% FPL CHIP (Unborn Option) Citizens & Legal Immigrants Income 139% to 214% FPL Documented/Undocumented Non-immigrants Income to 214% FPL If over the income limit for above (except for AG), consider Regular MNP and SD-MNP. (Non-immigrant pregnant women who fall to MNP can only be covered for emergency medical services, which include labor and deliver)

TCP Income to 138% FPL (family planning coverage only)