Page 3

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued May 1, 2023

Page 3 of H-3100 Replacing January 23, 2023 Revised/added text indicated by underscore

Deleted text indicated by “**”

H-3120.3 ESTABLISH NON-FINANCIAL ELIGIBILITY

Verify eligibility with regard to the following factors:

• Age - MAGI-Related

I-100

• Assignment of Third Party Rights I-200

• Citizenship / Identity and Qualified Non-Citizen Status I-300

• Enumeration

I-600

• Residence

I-1900

H-3120.4 ESTABLISH NEED

There are no income or resource tests in determining eligibility.

H-3120.5 ELIGIBILITY DECISION

Evaluate all requirements to determine eligibility.

H-3120.6 CERTIFICATION PERIOD

The certification period may be effective no earlier than three (3) months prior to the application date provided the individual is otherwise eligible. The months of retroactive coverage are not included in the twelve (12) month certification period. The twelve (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 (RME).

Note: Prior to closure of Former Foster Care Children, eligibility in other programs must be explored. H-3120.7 NOTICE OF DECISION

Send the appropriate notice of decision to the applicant/beneficiary.