Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued September 30, 2024

Page 2 of H-3020 Replacing August 11, 2023 Revised/added text indicated by underscore

Deleted text indicated by “**” H-3022.2 Establish Categorical Requirement

Each child must be under age 19.

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

H-3022.3 Establish Non-Financial Eligibility

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

• Assignment of Third Party Rights I-200

• Citizenship/Alien Status

I-300

• Enumeration

I-600

• Residence

I-1900

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

H-3022.4 Establish Need

Household composition and countable income for CHAMP children is based on MAGI income standards. 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 the CHAMP child income standard. Refer to Z-200 Federal Poverty Income Guidelines.

Note: In determining family size for the eligibility determination of a pregnant woman, she is counted as herself, plus each of the children she is expected to deliver. Do not include the unborn(s) in the family size for eligibility determinations of other household members.