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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 1, 2024 Page 2 of H-1500 Issued May 16, 2022 Revised/added text indicated by underscore Deleted text indicated by “**” The parent/caretaker or child(ren) must be included for all purposes (e.g. eligibility, determination of income) if the parent or caretaker relative or child(ren) would have been considered a member of the MAGI household at the time benefits were terminated.

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H-1531 ELIGIBILITY CRITERIA

Parents and other caretaker relatives qualify for TM if they:

• Were eligible for and received PCR coverage in at least three (3) of the six (6) months immediately preceding the month in which the parent/caretaker became ineligible for PCR due to new or increased MAGI earnings from employment.

• Lost eligibility under PCR due to earnings over the income standard for PCR, and

• Continue to live with a dependent child.

Child(ren) may be added if they:

• Live with the TM-eligible parent/caretaker relative,

• Are ineligible for the Champ/LaCHIP Medicaid program, and

• Meet age requirements. Refer to MEM I-100.

Note: A parent/caretaker from another state who received PCR in that state must receive PCR in Louisiana for at least (one) 1 month to qualify for TM. The months PCR was received in another state are counted in determining if the parent/caretaker meets the criteria of having received PCR in three (3) of the prior six (6) months.

There is no income test during the first six (6) month eligibility period.

The parents or caretaker relatives and dependent child(ren) continues to be eligible for TM unless the beneficiaries become ineligible based on one or more of the factors listed in H-1534 Reasons For Ineligibility.