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Louisiana Medicaid Eligibility Manual Eligibility Determinations Reissued July 18, 2025 Page 5 of H-1040 Replacing July 31, 2024

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from the gross earnings.

Step 6. Subtract $65 and one-half of the remainder of the earnings.

Step 7. The remainder is the countable earned income.

Step 8. Combine the countable earned and unearned income found in Step 3 and Step 7.

Step 9. Subtract the monthly MNIES for one (1) person.

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Step 10. Subtract allowable health insurance premiums. Refer to I- 1536 Deductions.

Note: Liability for health insurance premiums arises in the month payment is due, not the month (or months) for which coverage is purchased. Premiums must be paid by the applicant/beneficiary.

Example: Wife enters a nursing facility and her supplemental medical insurance premium is deducted from her husband’s payroll or retirement check. The premium is not an allowable deduction.

Step 11. Determine the allowable incurred medical expense. Refer to H-1011.5 Medical Expenses Allowed in the Spend- down Process and H-1011.6 Medical Expenses Not Allowed in the Spend-down Process.

Note: MNP regulations allow the State to project the LTC Medicaid facility rate for SD MNP-LTC purposes. SNF coinsurance charges cannot be projected. However, SNF coinsurance charges are allowable medical expenses and can be used in spend-down once the charges are incurred.

Example: The individual is receiving Medicare SNF services. The