Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued October 11, 2022

Page 3 of H-2900 Replacing May 09, 2022 Revised/added text indicated by underscore

Deleted text indicated by “**” H-2902.1 Determine Assistance Unit The assistance unit consists of the pregnant woman.

H-2902.2 Establish Categorical Requirement An applicant/beneficiary must be pregnant for each month of eligibility, except the 12 months of continous eligibility for extended postpartum.

Note: If a child under age 19 is eligible for both CHAMP and the PW program, enroll the child in CHAMP.

H-2902.3 Establish Non-Financial Eligibility Eligibility shall be verified with regard to the following factors: • Assignment of Third Party Rights

I-200 • Citizenship / Identity and Qualified Non-Citizen Status I-300 • Enumeration

I-600 • Residence

I-1900

Evaluate the need for Support Enforcement Services (SES). Refer to I-2000.

H-2902.4 Establish Need Household composition and need/countable income for the PW group are based on MAGI methodology. Refer to I-1550 MAGI Determinations.

Exception: When determining Medicaid eligibility for pregnant women under age 19, all income is disregarded. Compare MAGI-based income to PW group income standard. Refer to Z-200, Federal Poverty Income Guidelines.

Note: The pregnant woman’s household composition and income unit shall always include the unborn child(ren).