Page 4

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued February 3, 2026

Page 4 of H-3900

Revised/added text indicated by underscore

Deleted text indicated by “**”

H-3907 Eligibility Period

LaHIPP eligibility follows the individual’s insurance enrollment period.

LaHIPP participation will be terminated when: • The coverage is no longer cost-effective; • The Medicaid eligibility of the covered individual ends; • The employer-sponsored insurance ends or becomes unavailable; • The participant fails to submit the documentation needed to meet program requirements; • The primary holder moves out of state or • The primary holder dies.

H-3908 Securing Information to Determine Eligibility

Secure essential information for determining eligibility. Only require the applicant to provide information that cannot be obtained from other data sources and is necessary to make an eligibility determination or for purposes directly connected to the administration of the Medicaid State Plan.

If the applicant cannot furnish all of the required verifications at the time of application, send a missing information request that contains a list of the items or actions needed, with the deadline for submission specified. Allow at least ten (10) calendar days for an applicant/beneficiary to provide the requested verifications for applications and changes.

Allow at least thirty (30) calendar days for a beneficiary to provide the requested verifications for a renewal and change.

H-3909 Notice of Decision

LaHIPP Eligibility Advisors will issue a decision notice.

H-3910 Fair Hearing

Refer to T-100 GENERAL INFORMATION