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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 02, 2023

Page 1 of H-1020 Replacing June 3, 2021 Revised/added text indicated by underscore

Deleted text indicated by “**” H-1020 REGULAR AND SPEND DOWN MEDICALLY NEEDY – MAGI-RELATED

H-1021 ELIGIBILITY DETERMINATION PROCESS

Determine eligibility by applying the following criteria. The elements are listed in the most logical order, but all steps should be performed simultaneously.

H-1021.1 Determine Assistance Unit

Include anyone who was not eligible in a MAGI-related group because of income. Refer to I-1550, MAGI Determinations.

Reminder: Do not include sanctioned individuals. Do not add anyone to the original MAGI-related household

H-1021.2 Establish Categorical Requirements

Categorical requirements must have been established in the Parents and Caretaker Relatives Group, Pregnant Women Group or Children Under Age 19 Group.

Exception: MNP eligibility cannot be considered for beneficiaries in the optional Adult Group.

H-1021.3 Establish Nonfinancial Eligibility

Non-financial eligibility requirements must have been established in Parents and Caretaker Relatives Group, Pregnant Women Group or Children Under Age 19 Group:

• Age – MAGI-Related I-100

• Assignment of Third Party Rights I-200

• Citizenship/Identity and Qualified Non-Citizen Status I-300