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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 21, 2025 Page 2 of H-2400 Replacing March 14, 2023 Revised/added text indicated by underscore Deleted text indicated by “**” certified in RMA.

If not eligible for RCA, determine eligibility by applying the following criteria beginning with H-2415.1 Determine Assistance/Benefit Unit. The elements have been listed in the most logical order, but work on all steps simultaneously.

H-2415.1 DETERMINE ASSISTANCE/BENEFIT UNIT The assistance/benefit unit consists of the applicant, spouse, and/or any minor children living in the home. Each member of the unit must meet all eligibility requirements.

H-2415.2 ESTABLISH CATEGORICAL REQUIREMENT Establish that the applicant/beneficiary:

• Is a Refugee or Asylee; Cuban or Haitian entrant; Iraqi or Afghan Special Immigrant; severe trafficking victim (Refer to I-312 Qualified Alien); and

• Is not eligible for Medicaid or the Louisiana Children’s Health Insurance Program (LaCHIP); and

• Falls into the established time limit of twelve (12) months from the date of arrival in the United States (for refugees), or from the date asylum is granted (for asylees); and

• Is not enrolled as a full-time student in an institution of higher education, unless it is a one (1) year re-certification program that is part of the refugee’s Comprehensive Resettlement Plan (CSR); and

• Provides the name of the sponsoring RRA (Asylees are exempt from this requirement.); or

• A child may receive RMA coverage if both parents meet the RMA requirements or the mother is receiving RMA when the child is born. These newborns can receive RMA until the end of the mother’s period of eligibility.

H-2415.3 Establish Non-Financial Eligibility

Verify eligibility for each member of the assistance/benefit unit with regard to the following factors: