Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 21, 2025 Page 3 of H-2400 Replacing March 14, 2023 Revised/added text indicated by underscore Deleted text indicated by “**” • Assignment of Third Party Rights I-200 • Citizenship/Identity and Alienage I-300 • Enumeration I-600 • Residence

I-1900

H-2415.4 Establish Need

Household composition and countable income for RMA are based on MAGI. Refer to I-1550, MAGI Determinations.

There is no asset or resource test for the MAGI groups.

Compare the total countable income to the monthly Medically Needy Income Eligibility Standards (MNIES) for the number of individuals in the MAGI household.

If the income is equal to or less than the MNIES, the assistance unit is income eligible for RMA.

If the income is greater than the MNIES, the assistance unit is ineligible for RMA. Consider for the Spend Down Medically Needy Program - RMA.

Spend Down Medically Needy Program - RMA If the applicant has been determined income ineligible for Regular RMA, convert the monthly MAGI income to quarterly MAGI income by multiplying by three (3), subtract the quarterly MNIES for the number of individuals in the MAGI household, and subtract the medical bills from the excess income in the following order:

Step 1. Subtract allowable medical bills for individuals, other than the applicant, who are included in the MAGI household.

Step 2. Subtract unpaid medical bills for services received up to three (3) months prior to the month of application, in chronological order.

Step 3. Subtract allowable health insurance premiums. Refer to H-1011.5 Medical Expenses Allowed in the Spend-down Process.