Page 11

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 11 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” 1040 Spend-Down Medically Needy - Long Term Care – SSI-Related.

Note: Exclude any income received from VA Pension for Aid and Attendance from the gross income computation.

Add the gross earned and the gross unearned income, including any income deemed from the parent(s), and compare the total to the SIL. If the applicant/beneficiary is an individual, including a minor child who has income deemed from the parent(s), use the individual SIL.

If the total gross income of the applicant/beneficiary is greater than the SIL, the applicant/beneficiary is income ineligible. Consider eligibility for Spend-down MNP. Refer to H-1030 Spend-Down Medically Needy - SSI-Related or H-1040 Spend-Down Medically Needy - Long Term Care - SSI Related.

If the total gross income is equal to or less than the SIL, the applicant/beneficiary is income eligible. Continue the determination of need.

Reminder: Consider QMB or SLMB eligibility for all LTC applicants. Refer to H-1100 Qualified Medicare Beneficiary (QMB) or H-1300 Specified Low-income Medicare Beneficiary (SLMB).

Couples in the Same Facility

Beginning with the month that both the applicant/beneficiary and legal spouse reside in the same facility, determine whether it is to their advantage to have need considered: ● As a couple; or ● As individuals. First, consider eligibility for each member of the couple as an individual.

If one member of the couple has gross countable income greater than the SIL, consider eligibility as a couple.

If need is considered for the applicants/beneficiaries as a couple, use the couple SIL.