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Louisiana Medicaid Eligibility Manual Eligibility Determinations

September 15, 2023 Page 6 of H-1030 Replacing January 30, 2012

Revised/added text indicated by underscore

Deleted text indicated by “**”

Step 5. Subtract any remainder of the $20 SSI disregard from gross earnings.

Step 6. Subtract earned income deduction from the remaining gross earnings of the income unit. The earned income deduction is $65 and one half of the remainder of the earnings.

Step 7. The remainder is the countable earned income.

Step 8. Combine the remainders in Step 3 and Step 7 for the total countable income.

Step 9. Subtract the MNIES for 1 to determine the excess income to spend down.

Step 10. Subtract allowable health insurance premiums. Refer to H-1011.5, Bills Allowed in the Spend-Down Process and I- 1536 Deductions.

Note: Liability for health insurance premiums arises in the month payment is due, rather than in the month (or months) for which coverage is purchased.

Step 11. Subtract paid and unpaid bills including insurance co- payments and deductibles incurred for services received within the spend-down period, in chronological order (per diem if necessary), oldest to most recent.

Note: If multiple services are received on the same date, services verified as not covered by Medicaid or non- payable by Medicaid (because the provider does not 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