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Louisiana Medicaid Eligibility Manual Eligibility Determinations Reissued July 18, 2025 Page 3 of H-1040 Replacing July 31, 2024

Revised/added text indicated by underscore

Deleted text indicated by “**”

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Private payment charges incurred within the three months preceding the eligibility month may be used as medical deductions during the post-eligibility determination, provided they have not been previously allocated in a Spend-down MNP budget for an eligible month, and the individual is responsible for the payment.

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

H-1041.1 Determination of the Assistance/Benefit Unit

The assistance/benefit unit consists of the applicant/beneficiary.

H-1041.2 Establish Categorical Requirement

Verify that the applicant/beneficiary is:

• Aged,

• Blind, or

• Disabled.

Refer to E-0000 Category.

H-1041.3 Establish Non-Financial Eligibility

Verify eligibility for each member of the assistance/benefit unit with regard to the following factors:

• Assignment of Third Party Rights

I-200

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

• Continuity of Stay (LTC Only, Except HCBS)

I-400

• Enumeration

I-600

• Medical Certification

I-1000