Page 5

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 1, 2024 Page 5 of H-1500 Issued May 16, 2022 Revised/added text indicated by underscore Deleted text indicated by “**” no longer remains TM eligible.

● MAGI income exceeds 190 percent FPIG (185% plus 5% disregard). Refer to Z-200 Federal Poverty Income Guidelines. Termination is not retroactive.

• The residency requirement is not met.

● The parent/caretaker had no earnings in one or more of the previous three (3) months.

Exception: If lack of earnings was due to involuntary loss of employment, illness, or if the beneficiary can establish satisfactory other good cause for failure to earn, the parent/caretaker continues to be TM eligible.

H-1535 NOTICES

At the time eligibility is determined for TM, a notice of decision is sent.

Consideration for coverage under all other Medicaid programs is required for parents/caretakers who lose TM eligibility.

Advance notice of decision is sent to the beneficiary at any time case closure is proposed. This includes closures for failure to respond to the renewal process or when TM eligibility is exhausted and other eligibility is not established.

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Page 5

Official source

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 1, 2024 Page 5 of H-1500 Issued May 16, 2022 Revised/added text indicated by underscore Deleted text indicated by “**” no longer remains TM eligible.

● MAGI income exceeds 190 percent FPIG (185% plus 5% disregard). Refer to Z-200 Federal Poverty Income Guidelines. Termination is not retroactive.

• The residency requirement is not met.

● The parent/caretaker had no earnings in one or more of the previous three (3) months.

Exception: If lack of earnings was due to involuntary loss of employment, illness, or if the beneficiary can establish satisfactory other good cause for failure to earn, the parent/caretaker continues to be TM eligible.

H-1535 NOTICES

At the time eligibility is determined for TM, a notice of decision is sent.

Consideration for coverage under all other Medicaid programs is required for parents/caretakers who lose TM eligibility.

Advance notice of decision is sent to the beneficiary at any time case closure is proposed. This includes closures for failure to respond to the renewal process or when TM eligibility is exhausted and other eligibility is not established.