Page 7

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued July 31,2024

Page 7 of H-1050 Replacing November 06, 2023

Revised/added text indicated by underscore

Deleted text indicated by “**” If the applicant/beneficiary has a community spouse, refer to I-1660 Spousal Impoverishment Resource Provisions.

Resources transferred for less than FMV within the 60 month look back-period make the applicant/beneficiary ineligible for the waiver program for the duration of the penalty period. Refer to I-1670 Transfer for Less than FMV.

Equity interest in home property that exceeds the allowable home equity limit makes the applicant/beneficiary resource ineligible for the waiver program.

Eligibility should be considered in other non-waiver programs.

• Compare total countable resources to the LTC resource limit for an individual. Refer to Z-900 Resource Limits by Program.

If resources are equal to or less than the individual resource limit, the applicant/beneficiary is resource eligible for HCBS. Continue the determination of need.

If resources are greater than the individual resource limit, the applicant/beneficiary is resource ineligible for HCBS.

H-1051.5 Determine the Patient Liability

Post-eligibility treatment of income (PETI) rules are used to calculate an applicant/beneficiary’s contribution to their cost of care for nursing home, Home and Community Based Waiver or ICF/IID services. Also called patient liability (PLI). PLI is the amount the applicant/beneficiary must pay towards their monthly cost of care. It is based on the amount of monthly income remaining after allowable deductions.

Refer to I-1538 Patient Liability-Post Eligibility Treatment of Income (PETI) for the Patient Liability calculation process.

** The monthly patient liability will be paid directly to the waiver services