Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued March 01, 2024

Page 2 of H-1000 Replacing February 2, 2017 Revised/added text indicated by underscore

Deleted text indicated by “**” H-1011 MNP GROUPS

There are three (3) MNP groups.

1) MAGI-related Regular Medically Needy

Individuals or families who have income which is at or below the MNIES. Regular Medically Needy is only applicable to MAGI-related eligibility groups.

2) Spend-down Medically Needy

Spend-Down MNP is considered after establishing income ineligibility in Regular MNP or a Non-MAGI related eligibility group and excess income remains.

The following individuals may be considered for Spend-down MNP:

• Individuals or families who meet the requirements in a MAGI-related eligibility group. Refer to H-1020;

• Non-institutionalized individuals or couples who meet the requirements in a Non-MAGI related eligibility group. Refer to H-1030;

• Institutionalized individuals who have been, or are expected to be in a medical institution for a continuous period of thirty (30) days, and have income which exceeds the individual Federal Benefit Rate (FBR). Refer to H-1030; or

• Institutionalized individuals residing in a long-term care facility with Medicare coinsurance who have income which exceeds the special income level (SIL). The SIL is three (3) times the current FBR. Refer to H-1030.

3) LTC/HCBS Spend-down Medically Needy

Individuals residing in a Medicaid long term care (LTC) facility who are not on Medicare coinsurance or individuals offered a waiver opportunity for home and community-based services (HCBS) who have income which exceeds the SIL.

Refer to H-1040 and H-1050 for instructions.