Page 12

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 12 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” If the combined total gross income of the couple is equal to or less than the couple SIL, the applicants/beneficiaries are income eligible. Continue the determination of need using the couple resource limit.

If need is considered for the applicant/beneficiary as a couple, eligibility for Qualified Medicare Beneficiary (QMB) and/or Specified Low-Income Medicare Beneficiary (SLMB) should be reviewed using the couple QMB/SLMB standard.

If the combined gross income of the couple exceeds the couple SIL, the couple is income ineligible. Re-evaluate the eligibility of each member as an individual using the individual’s income and comparing it to the individual SIL. If the individual’s total gross income is equal to or less than the SIL, the individual is income eligible.

If one or both members of the couple remain income ineligible when considered as an individual, determine individual eligibility in 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.

C. Determine Composition of the Resource Unit

The resource unit consists of:

 The applicant/beneficiary;

 The applicant/beneficiary and the community spouse;

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

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

D. Determine Countable Resources

Determine eligibility with regard to resources.