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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued July 10, 2025 Issued October 17, 2022

Page 2 of H-2100 Revised/added text indicated by underscore

Deleted text indicated by “**”

• Have countable assets less than $25,000; and

• Take no-cost health insurance, if available.

Beneficiaries are eligible for full Medicaid coverage.

Note: Eligibility for this program terminates the month the beneficiary turns age 65. H-2120 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-2120.1 Determine Assistance Unit

The assistance unit consists of the applicant/beneficiary.

H-2120.2 Establish Categorical Requirement

Verify that the applicant/beneficiary:

• Is at least age 16, but not yet 65;

• Has a medically determinable physical or mental impairment which meets the Social Security Administration’s definition of disability. Substantial gainful activity is not a factor; and

• Is employed or self-employed.

There is no minimum work or earnings requirement. Employment is defined as a reasonable work effort for which a person receives financial compensation and pays all applicable federal, state, and payroll taxes.

H-2120.3 Establish Non-Financial Eligibility

Verify eligibility for the applicant/beneficiary with regard to the following factors: