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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued March 24, 2025 Replacing October 17, 2022

Page 18 of H-600 Revised/added text indicated by underscore

Deleted text indicated by “**”

Step 1. Determine current RSDI.

Step 2. Subtract the amount of the RSDI COLA which caused SSI/MSS ineligibility.

Step 3. Subtract all RSDI COLAs received subsequent to the loss of SSI.

Step 4. The remainder is the countable RSDI.

Step 5. Add any other countable unearned income.

Step 6. Subtract $20 SSI disregard from unearned income.

Step 7. Determine total gross earned income.

Step 8. Subtract any balance of $20 SSI disregard from gross earnings.

Step 9. Subtract earned income deduction of $65 and one-half of the remainder from remaining gross earnings.

Step 10. Combine amounts from Steps 6 and 9.

Step 11. Compare total countable income to the current FBR for Individual. If income is greater than the individual limit, the applicant/beneficiary is income ineligible.

Note: An individual who loses SSI benefits because of receipt of a Title II (RSDI) COLA which increases their countable income to exactly the amount of the FBR (non-pay status EO1/NO1) is technically entitled to SSI and thus, Medicaid eligible under the Pickle Amendment (Group One).

Ineligible Spouse Deeming

If there is an ineligible spouse with income, complete steps 1 through 11 above using only the applicant’s/beneficiary’s income. If the income is greater than the individual limit, the applicant/beneficiary is ineligible and there is no need to deem. Consider MNP. If the applicant's/recipient's income is equal to or less than the individual limit, apply deeming policy, I-1424.2 Income Deeming Procedures.