Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued June 30, 2023

Page 3 of H-2000 Replacing February 28, 2020 Revised/added text indicated by underscore

Deleted text indicated by “**”

• Applicant/beneficiary and ineligible spouse living in the home; or • Applicant/beneficiary and eligible spouse who are living in the same home (eligible couple). Note: If the SSA considers the applicant/beneficiary and their spouse as a couple for SSI purposes, they are considered as an eligible couple for the purposes of budgeting in the Medicare Savings Programs (QMB, SLMB, QI). An eligible spouse is one who is aged, blind, or disabled and lives in the same household as the applicant/beneficiary. The eligible spouse does not have to be entitled to Medicare for the couple to be considered an eligible couple.

B. Determine Need/Countable Income

Individual

If the applicant/beneficiary is an individual with no spouse or with an ineligible spouse with no income, complete the following budget steps:

Step 1. Determine total gross unearned income.

Step 2. Subtract the $20 SSI general disregard from unearned income.

Step 3. The remainder is the countable unearned income.

Step 4. Determine the total gross earned income.

Step 5. Subtract any remainder of the $20 SSI disregard from gross earnings.

Step 6. Subtract the earned income deduction from remaining gross earnings. Earned income deduction is $65 and one half of remainder of earnings.

Step 7. The remainder is the countable earned income.

Step 8. Add the remainders from Step 3 and Step 7.

Step 9. Compare the total to 135 percent FPL for one person. Refer to Z-200 Federal Poverty Income Guidelines.

If the remaining income is equal to or greater than the QI income limit for one person, the applicant/beneficiary is income ineligible.