Page 5

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued June 30, 2023

Page 5 of H-2000 Replacing February 28, 2020 Revised/added text indicated by underscore

Deleted text indicated by “**”

Step 7. The remainder is the couple’s countable earned income.

Step 8. Combine the remainders in Step 3 and Step 7.

Step 9. Compare the total countable income to the 135 percent FPL for two persons. Refer to Z-200 Federal Poverty Income Guidelines.

If the income is equal to or greater than the QI income limit for two (2) persons, the applicant/beneficiary is not eligible.

If the income is less than the QI income limit for two (2) persons, the applicant/beneficiary is income eligible.

H-2020.5 Eligibility Decision

Evaluate all eligibility requirements and verification received to

make the eligibility decision.

H-2020.6 Certification Period

The certification period can be effective no earlier than three (3) months prior to the application date provided the individual is otherwise eligible and is enrolled in Medicare Part A.

Coverage of QI is mandatory. However, federal funds are limited. Therefore, the state is authorized to limit participation so that the total assistance provided is (on an estimated basis) equal to, but not greater than the funding allocated to the state for participation.

Individuals who are eligible for QI shall be certified on a first come, first served basis. Individuals who were receiving assistance either under QI, in December of the previous year and remain eligible, or in the case of QMB or SLMB, become eligible under the QI program, must be given preference. Once an individual is determined eligible, he/she is entitled to receive assistance for a twelve (12) month certification period as long as he/she remains eligible and funding for the program is available.

H-2020.7 Notice of Decision

Send the appropriate notice of decision to the applicant/beneficiary.

Note: Applicants enrolled in Medicare Part A are not referred to the