Page 2

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued May 1, 2023

Page 2 of H-3050 Replacing July 7, 2016 Revised/added text indicated by underscore

Deleted text indicated by “**” to the following factors:

• Assignment of Third Party Rights I-200

• Citizenship/Alien Status

I-300

• Enumeration

I-600

• Residence

I-1900

• Creditable Health Coverage

I-2200

For LaCHIP Phase IV, citizenship/non-citizen status and enumeration are not eligibility requirements. Attempt to obtain and document any information the applicant can offer for herself and income unit members.

Applicants must be uninsured at the time of application. Applicants are considered to be uninsured if they do not have creditable health insurance that provides coverage of prenatal care services.

For LaCHIP Phase IV, an applicant cannot have access to a state employee health benefits plan (SEHBP) that covers prenatal services. A SEHBP is defined as a plan that is offered or organized by the state government, or on behalf of state employees, or other public agency for employees within the state.

H-3052.4 Establish Need

Household composition and countable Income for LaCHIP Phase IV Children is based on MAGI. Refer to I-1550 MAGI Determinations.

Compare MAGI-based income to the LaCHIP Phase IV income standard. Refer to Z-200 Federal Poverty Income Guidelines. H-3052.5 Eligibility Decision

Evaluate all eligibility requirements and verifications received to make the eligibility decision to either reject or certify the case.