Page 4

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued September 23, 2024 Page 4 of H-3600 Replacing October 17, 2022 Revised/added text indicated by underscore Deleted text indicated by “**”

H-3621.2 Establish Categorical Requirement

Verify that the applicant/beneficiary is:

• Aged;

• Blind; or

• Disabled.

Refer to E-0000 Category.

H-3621.3 Establish Non-Financial Eligibility

Verify eligibility for the applicant/beneficiary with regard to the following factors:

• Assignment of Third Party Rights

I-200

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

• Continuity of Stay (LTC Only, Except HCBS) I-400

• Enumeration

I-600

• Medical Certification (LTC and HCBS Only) I-1000

• Residence

I-1900

H-3621.4 Establish Need

Verify that the applicant/beneficiary is receiving or plans to receive PACE services from a Medicaid-enrolled PACE provider.

A. Determine Composition of the Income Unit

The income unit consists of:

• The applicant/beneficiary; or

• Applicants/beneficiaries who are a couple (legally married)