Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued Feburary 13, 2025

Page 2 of H-1400 Replacing November 22, 2022

Revised/added text indicated by underscore

Deleted text indicated by “**”

- Her lifetime limit on all benefits under the plan has been exhausted, - She is in a period of exclusion (such as a pre-existing condition exclusion) for treatment of breast and/or cervical cancer, or - She is an American Indian or Alaska Native woman eligible for health care services provided under a medical care program of the Indian Health Service or of a tribal organization.

H- 1410.1 COVERAGE

Beneficiaries are eligible for full Medicaid coverage. Coverage is not limited to the treatment of breast and/or cervical cancer.

H-1420 ELIGIBILITY DETERMINATION PROCESS

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

H-1420.1 DETERMINE ASSISTANCE UNIT

The assistance unit includes the applicant/beneficiary.

H-1420.2 ESTABLISH CATEGORICAL REQUIREMENT

Verification must be provided that applicant is under age 65 and has been screened for breast and/or cervical cancer under the LBCHP and found to need treatment for breast and/or cervical cancer (including a pre-cancerous condition).

H-1420.3 ESTABLISH NON-FINANCIAL ELIGIBILITY

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

• Assignment of Third Party Rights I-200

• Citizenship/Alien Status

I-300