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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 1, 2024 Page 3 of H-1500 Issued May 16, 2022 Revised/added text indicated by underscore Deleted text indicated by “**” H-1532 PERIOD OF ELIGIBILITY

A new application is not required for TM. Eligibility begins with the first month of PCR ineligibility. If earnings were not reported timely, the parent/caretaker is still entitled to the first six (6) months of TM, but may receive Medicaid under an incorrect type case (for example, PCR rather than TM).

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TM is not available to a parent/caretaker if it is determined that, at any time in the last six (6) months of receipt of PCR, the parent/caretaker was ineligible because of fraud.

TM may continue for up to twelve (12) months if certain eligibility requirements are met.

If a parent/caretaker again becomes PCR eligible during the twelve (12) months of TM, the family may choose between TM and PCR.

If the parent/caretaker chooses PCR and subsequently becomes ineligible for that program, the parent/caretaker may be eligible for:

1) A new period of continued benefits. To be eligible for a new period, the parent/caretaker would have to again meet the requirements to establish initial eligibility (such as the requirement for PCR eligibility in three (3) of the preceding six (6) months); or

2) The remainder of the original period of continued benefits. To qualify for the remainder of the original period of continued eligibility, the parent/caretaker would have to lose eligibility for a reason related to employment. The parent/caretaker would not have to meet the requirement for PCR eligibility in three (3) of the preceding six (6) months.

H-1533 REPORTING REQUIREMENTS FOR TRANSITIONAL MEDICAID

Once in TM, the beneficiary must continue to report any changes in household composition and gross earnings as they occur.

Evaluate changes reported by the beneficiary for continuing eligibility. Refer to H-1532 Period of Eligibility and H-1534 Reasons For