Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued October 11, 2022

Page 2 of H-2900 Replacing May 09, 2022 Revised/added text indicated by underscore

Deleted text indicated by “**” March she had no income. Certification is effective March through the month in which the 12 months of continous eligibility for extended postpartum ends.

If application is made after the month the postpartum period ends, the period of eligibility will be retroactive but shall not start more than three (3) months prior to the month of application.

The start date of retroactive eligibility is determined by counting back three (3) months prior to the date of application. The start date will be the first day of that month.

Example: Jane Doe applies on June 16th, but delivered her baby in May. The start date would be March 1, if all eligibility requirements are met.

Eligibility may not extend past the month in which the 12 months of continous eligibility for extended postpartum ends.

The applicant/beneficiary must be income eligible during the initial month of eligibility only. Changes in income after the initial month will not affect eligibility.

Coverage

Beneficiaries in this group receive full Medicaid coverage. Coverage includes: • Prenatal care; • Delivery; • Postpartum care for twelve (12) months; and • Any conditions that may affect the health of the pregnant woman, and subsequently the outcome of the pregnancy, as determined by the provider. H-2902 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.