Page 5

Louisiana Medicaid Eligibility Manual Eligibility Determinations

September 15, 2023 Page 5 of H-1030 Replacing January 30, 2012

Revised/added text indicated by underscore

Deleted text indicated by “**”

accept Medicaid) should be used first and then hospital bills.

On the date excess income is “spent down” (income equal to allowed medical expenses) the applicant is eligible for Spend-down MNP. This date is referred to as the spend-down date. Eligibility begins the date the excess income is spent down. If there is no Medicaid liability in the month that the income is spent down, eligibility begins the first day of the month after the spend-down date in which there is a Medicaid liability or the first day of the month of the requested period of coverage, whichever is earlier.

D. Determine Need/Countable Income - Institutionalized on Medicare Co insurance - Spend-down MNP

Individual

If the applicant is an individual with no spouse or with an ineligible spouse with or without income, go to Step 1. There is no deeming from a spouse or to a child.

Couple

If both members of a couple are in a facility on Medicare co insurance, and each member’s income is over the SIL, go to Step 1 and review each member as an individual.

Note: When one member of the couple is income ineligible, consider as a couple using the couple SIL before reviewing for Spend- down MNP. If the combined income of the couple exceeds the couple SIL, re-evaluate eligibility as individuals. (Refer to ** MEM H-831.4 B Long Term Care - Couples in the Same Facility)

Budget Steps

Step 1. Determine unearned income of applicant(s).

Step 2. Subtract one $20 SSI disregard per income unit, if applicable.

Step 3. The remainder is the countable unearned income.

Step 4. Determine total gross earnings of applicant(s).