Page 1
Louisiana Medicaid Eligibility Manual Eligibility Determinations
March 24, 2025
Page 1 of H-3040 Replacing March 01, 2024 Revised/added text indicated by underscore
Deleted text indicated by “**” H-3040 CHILDREN UNDER AGE 19-LACHIP AFFORDABLE PLAN H-3041 GENERAL INFORMATION
Effective June 1, 2008, Louisiana expanded the State Child Health Insurance Program (SCHIP) to provide health assistance to uninsured children with family income in excess of the limits for the regular Louisiana Children’s Health Insurance Program (LaCHIP), but equal to or less than 255 percent (250 percent, plus a 5 percent disregard) of the Federal Poverty Level (FPL).
The LaCHIP Affordable Plan (LAP) is a separate state SCHIP program. LAP is a cost-sharing program with a monthly premium of $50 per household, regardless of the number of certifications per household due to multiple income units. A household that has at least one (1) eligible child verified as a member of a federally-recognized American Indian or Alaskan native tribe will pay no premium.
Eligibility for applicants/beneficiaries for LAP is determined by using the Modified Adjusted Gross Income (MAGI) methodology.
A LAP child is one: • Who is under age 19; • Who is income ineligible for regular LaCHIP; • Who has MAGI-based income that does not exceed 255 percent of the FPL; • Who does not have other insurance or access to the State Employees Health Plan (SEHP); • Who has been determined eligible for child health assistance under the SCHIP; • **
H-3042 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. H-3042.1 Determine Assistance Unit