Page 3

Louisiana Medicaid Eligibility Manual

Eligibility Determinations

Issued July 20, 2020

Page 3 of H-3400 Replacing June 14, 2016

Deleted text indicated by “**” Revised/added text indicated by underscore

H-3420.5 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 twelve (12) month certification period begins with the month of application. The months of retroactive coverage are not included in the twelve (12) month certification period.

** Note: If otherwise eligible, an individual may be enrolled in TCP and a limited benefit program such as the Medicare Savings programs (QMB, SLMB, or QI). Retroactive medical eligibility (RME) shall be explored for the three (3) months prior to the month of application. Refer to H-1800, Retroactive Medical Eligibility (RME).

H-3420.6 NOTICE OF DECISION Send the notice of decision to the applicant/enrollee.

H-3420.7 RENEWALS TCP eligibility is reviewed every twelve (12) months. **

Renewal Eligibility Decision If eligibility is extended, a notice of decision is sent to the enrollee. If eligibility is not extended, an advance notice of decision is sent, advising the enrollee of the proposed action.

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Page 3

Official source

Louisiana Medicaid Eligibility Manual

Eligibility Determinations

Issued July 20, 2020

Page 3 of H-3400 Replacing June 14, 2016

Deleted text indicated by “**” Revised/added text indicated by underscore

H-3420.5 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 twelve (12) month certification period begins with the month of application. The months of retroactive coverage are not included in the twelve (12) month certification period.

** Note: If otherwise eligible, an individual may be enrolled in TCP and a limited benefit program such as the Medicare Savings programs (QMB, SLMB, or QI). Retroactive medical eligibility (RME) shall be explored for the three (3) months prior to the month of application. Refer to H-1800, Retroactive Medical Eligibility (RME).

H-3420.6 NOTICE OF DECISION Send the notice of decision to the applicant/enrollee.

H-3420.7 RENEWALS TCP eligibility is reviewed every twelve (12) months. **

Renewal Eligibility Decision If eligibility is extended, a notice of decision is sent to the enrollee. If eligibility is not extended, an advance notice of decision is sent, advising the enrollee of the proposed action.