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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued Feburary 06, 2023 Page 3 of H-1300 Replacing March 13, 2020 Revised/added text indicated by underscore Deleted text indicated by “**” the following factors:

• Assignment of Third Party Rights I-200

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

• Enumeration

I-600

• Residence

I-1900

H-1321.4 ESTABLISH NEED

A. Determine Composition of the Income Unit

The income unit includes the:

• Applicant/beneficiary,

• Applicant/beneficiary and ineligible spouse living in the Home, or

• Applicant/beneficiary and eligible spouse who are living in the same home (eligible couple).

Note: If the SSA considers the applicant/beneficiary and their spouse as a couple for SSI purposes, they are considered as an eligible couple for purposes of budgeting in the Medicare Savings Programs (QMB, SLMB, or QI). An eligible spouse is one who is aged, blind, or disabled and lives in the same household as the applicant/beneficiary. The eligible spouse does not have to be entitled to Medicare for the couple to be considered an eligible couple.

B. Determine Need/Countable Income Individual

If the applicant/beneficiary is an individual with no spouse or with an ineligible spouse with no income, complete the following budget steps:

Step 1. Determine total gross unearned income.

Step 2. Subtract the $20 SSI general income disregard from unearned income.