Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued August 11, 2023

Page 3 of H-3030 Replacing March 3, 2021 Revised/added text indicated by underscore

Deleted text indicated by “**” H-3032.3 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/Identity and Qualified Non-Citizen Status I-300 • Enumeration I-600 • Residence I-1900 • Lack of Creditable Health Coverage I-2200

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

H-3032.4 Establish Need

Household composition and countable income for LaCHIP Children is based on MAGI. Refer to I-1550, MAGI Determinations.

Compare MAGI-based income to LaCHIP Children Income Standard. Refer to Z-200, Federal Poverty Income Guidelines.

H-3032.5 Eligibility Decision

Evaluate all eligibility requirements and verifications received to make the eligibility decision to either reject/close, certify, or extend eligibility.

H-3032.6 Certification Period

The certification period may be effective no earlier than three months prior to the application date provided the individual is otherwise eligible. The 12-month certification period begins with the month of application.

Retroactive medical eligibility shall be explored for the three months prior to the month of application. Refer to H-1800, Retroactive Medical Eligibility.