Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued July 22, 2020

Page 3 of H-1200 Replacing May 22, 2020

Deleted text indicated by “**” Revised/added text indicated by underscore

H-1221.3 Establish Non-Financial Eligibility

Verify eligibility for the applicant/enrollee with regard to the following factors:

 Assignment of Third Party Rights I-200

 Citizenship/Alien Status

I-300

 Enumeration

I-600

 Residence

I-1900

H-1221.4 Establish Need

A. Determine Composition of the Income/Resource Unit

The income/resource unit consists of:

● Applicant/enrollee; or

● Applicant/enrollee and ineligible spouse living in the home; or

● Applicants/enrollees who are a couple living in the same home (eligible couple).

Note: If SSA considers the applicants/enrollees as a couple for SSI, they are considered an eligible couple for the purposes of budgeting in the Medicare Savings Programs. A categorically eligible spouse is one who is aged, blind, or disabled and lives in the same household of the eligible individual. The eligible spouse does not have to be entitled to Medicare for the couple to be considered an eligible couple.

B. Determine Need/Countable Resources

Determine the total countable resources of the members of the income/resource unit. Refer to I-1630 SSI-Related Resources.