Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued June 30, 2023

Page 2 of H-2000 Replacing February 28, 2020 Revised/added text indicated by underscore

Deleted text indicated by “**”

Note: Although the online Self Service Portal (SSP) and BHSF Form 1-MB, Application for Medicare Savings Program, are commonly used to apply for initial or continued QI benefits, it is also acceptable to use BHSF Form 1-A, Application for Health Coverage.

H-2020 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-2020.1 Determine Assistance/Benefit Unit

The assistance/benefit unit consists of the applicant(s)/beneficiary(ies).

H-2020.2 Establish Categorical Requirement

Verify ** enrollment in Medicare Part A for the applicant/beneficiary. Medicare Part A eligibility, the start date for Medicare Part A, and the Medicare claim number can be verified through the interfaces available in LaMEDS.

H-2020.3 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/Identity and Qualified Non-Citizen Status I-300 • Enumeration

I-600 • Residence

I-1900

H-2020.4 Establish Need

A. Determine Composition of the Income Unit

The income unit includes the: • Applicant/beneficiary;