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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 10 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**”  Assignment of Third Party Rights

I-200  Citizenship/Identity/Qualified Non-Citizen Status

I-300  Continuity of Stay

I-400  Enumeration

I-600  Medical Certification

I-1000  Residence

I-1900

H-831.4 Establish Need Verify that the applicant/beneficiary is medically certified and receiving LTC services from a Medicaid enrolled provider.

A. Determine Composition of the Income Unit

The income unit consists of:

● The applicant/beneficiary;

● Applicants/beneficiaries who are a couple (legally married) residing in the same facility; or

● For the month of admission, the applicant/beneficiary who is a minor child and the parent(s) with whom they lived during the month. Refer to I-1420 Need - Deeming. After the first month of eligibility, the income/resource unit consists of the applicant/beneficiary.

Note: Never consider the income of the community spouse/legal dependent(s) at home in determining eligibility for an institutionalized applicant/beneficiary. Refer to I-1537 Spousal Impoverishment Income Provisions.

B. Determine Need/Income

Determine the gross income of the applicant/beneficiary including any income deemed from the parent(s). Refer to I-1530 Need - SSI-Related Income.

The applicant/beneficiary must be income eligible based on gross income. If the gross income before any deductions or allowances is greater than the SIL consider eligibility for Spend-down MNP. Refer to H-1030 Spend-Down Medically Needy - SSI-Related or H-