Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 02, 2023

Page 2 of H-1020 Replacing June 3, 2021 Revised/added text indicated by underscore

Deleted text indicated by “**” • Enumeration I-600

• Residence I-1900

H-1021.4 Establish Need

Household composition for MAGI-related MNP shall only include those individuals that were in the original MAGI household. Refer to I-1550, MAGI Determinations.

Regular Medically Needy

Compare the total countable income to the monthly MNIES for the number of people in the MAGI household.

If income is equal to or less than the MNIES, the assistance unit is income eligible for Regular MNP.

If income is greater than the MNIES, the assistance unit is ineligible for Regular MNP. Consider for Spend-down MNP.

Spend-down Medically Needy

If the applicant has been determined income ineligible for Regular MNP, convert monthly MAGI income to quarterly MAGI income by multiplying by three, subtract quarterly MNIES for the number of people in the MAGI household, and subtract medical bills from the excess income in the following order:

Step 1. Subtract allowable bills for individuals other than the applicant who are included in the MAGI Household.

Step 2. Subtract unpaid bills for services received up to 3 months prior to the month of application in chronological order.

Step 3. Subtract allowable health insurance premiums. Refer to H-1011.5, Bills Allowed in the Spend-down process.

Note: Liability for health insurance premiums arises in the month payment is due, rather than in the month (or