Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued Feburary 13, 2025

Page 3 of H-1400 Replacing November 22, 2022

Revised/added text indicated by underscore

Deleted text indicated by “**”

• Enumeration

I-600

• Residence

I-1900

• Creditable Health Insurance

I-2200

H-1420.4 ESTABLISH NEED

All income and resources are exempt for BCC Medicaid.

Note: To be eligible for a LBCHP screening, household income must be below 250 percent of the poverty level and is determined by LBCHP.

H-1420.5 ELIGIBILITY DECISION

Evaluate all eligibility requirements and verifications received, to make an eligibility decision.

H-1420.6 ELIGIBILITY PERIOD

Eligibility may begin up to three (3) months prior to the date of application if program requirements are met. Eligibility for coverage ends when the beneficiary’s course of treatment is complete or the state has determined the enrollee no longer meets the eligibility criteria for the program.

A beneficiary is not limited in the number of eligibility periods for which they may receive coverage under the BCC program. A new period of eligibility may begin each time an applicant/beneficiary has been screened under the LBCHP, found to need treatment for breast and/or cervical cancer, and meets all other eligibility criteria.

H-1420.7 CERTIFICATION PERIOD

The initial certification period shall not exceed six (6) months, including any retroactive coverage.

Retroactive medicaid eligibility shall be explored for the three (3) months prior to the month of application. Refer to H-1800 Retroactive Medical Eligibility (RME).