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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued October 21, 2025 Page 4 of H-2400 Replacing March 14, 2023 Revised/added text indicated by underscore Deleted text indicated by “**” Note: Liability for health insurance premiums arises in the month payment is due, rather than in the month(s) for which coverage is purchased.

Step 4. Subtract paid and unpaid bills incurred for services received within the spend-down quarter, from oldest to most recent (per diem if necessary). Include insurance co-payments and deductibles. Hospital bills shall be used before physician bills in the spend-down process.

The applicant is eligible for the Spend-Down Medically Needy Program - RMA on the date the excess income is equal to the allowed medical expenses (or “spent-down”).

Reminder: When determining eligibility:

• Do not consider in-kind services and shelter provided by an applicant’s sponsor or local resettlement agency;

• Do not consider any cash assistance payments provided to an applicant; and

• Do not average income over the application processing period. Use the applicant’s income on the date of application.

H-2415.5 Eligibility Decision Evaluate all eligibility requirements and verification received to make the eligibility decision to either reject, close, certify, or extend eligibility.

H-2415.6 Eligibility Period For individuals enrolled on or after October 1, 2021, the certification period shall not exceed twelve (12) months. For individuals enrolled on or after May 5, 2025, the certification period is limited to a maximum of four (4) months. For persons granted asylum, the entry date is the date the individual is granted asylum. Once certified, increased earnings from employment shall not affect the applicant/beneficiary’s eligibility for RMA.

Note: The initial date of eligibility for Ukrainian Humanitarian Parolees (UHP) is