Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

March 24, 2025

Page 2 of H-3040 Replacing March 01, 2024 Revised/added text indicated by underscore

Deleted text indicated by “**” The assistance unit consists of the child(ren) under age 19.

H-3042.2 Establish Categorical Requirement

Each eligible child must be under age 19.

H-3042.3 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 • Creditable Health Coverage I-2200 • Access to a SEHP • Employer sponsored insurance not voluntarily cancelled during the prior three (3) months.

H-3042.4 Establish Need

Household composition and countable income for LaCHIP Affordable Plan children are based on the MAGI methodology. Refer to I-1550 MAGI Determinations.

Compare MAGI-based income to the LAP income standard. Refer to Z-200, Federal Poverty Income Guidelines.

H-3042.5 Eligibility Decision

Evaluate all eligibility requirements and verifications received to make the eligibility decision.

H-3042.6 Certification Period