Page 3

Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued April 18, 2022

Page 3 of H-700 Replacing November 1, 2000

Deleted text indicated by “**” Revised/added text indicated by underscore H-715 INCOME REJECTIONS Explore retroactive eligibility in MNP for an individual who was not eligible for SSI Retroactive Medicaid because of income. H-716 RESERVED H-721 ELIGIBILITY DETERMINATION PROCESS Determine eligibility for each month in the retroactive period by applying the following criteria. The elements have been listed in the most logical order, but work on all steps simultaneously.

H-721.1 Determine Assistance/Benefit Unit The assistance unit includes the applicant/beneficiary or both members of a couple (legal or non-legal spouse) if they both meet the SSI Medicaid criteria.

H-721.2 Establish Categorical Requirement Verify that the applicant/beneficiary was:

● Aged,

● Blind, or

● Disabled.

Refer to E-0000, Category.

H-721.3 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

• Enumeration I-600

• Residence I-1900