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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 13 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” Determine the total countable resources of the applicant/beneficiary. Refer to I-1630 Need - SSI-Related Resources.

If resources were disposed of or a trust was established within 60 months prior to application, refer to I-1670 Transfer of Resources for Less Than Fair Market Value. If the applicant/beneficiary is ineligible for vendor payment because of a transfer of resources for less than the fair market value (FMV), consider eligibility for Medicaid benefits without vendor payment.

If the applicant/beneficiary’s equity interest exceeds the allowable home equity limit, consider eligibility for Medicaid benefits without vendor payment. Refer to I-1634 Types of Resources (SSI- Related), Individuals with Substantial Home Equity.

For an applicant/beneficiary who entered the facility on or after September 30, 1989, and has a spouse in the community, refer to I-1660 Spousal Impoverishment Resource Provisions (LTC/HCBS).

Compare the total countable resources to the resource limit for an individual (or couple). Refer to Z-900 Resource Limits by Program .

If the countable resources are greater than the resource limit, the applicant/beneficiary is resource ineligible for LTC.

If the countable resources are equal to or less than the resource limit, the applicant/beneficiary is resource eligible for LTC.

If the resources of a couple are greater than the couple resource limit, consider eligibility for each member of the couple as an individual.

Note: If considered as an individual for resource purposes, the applicant/beneficiary shall also be considered as an individual for income purposes.

H-831.5 Eligibility Determination

Evaluate all eligibility requirements and verification received to make the eligibility determination.

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).

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Page 13

Official source

Louisiana Medicaid Eligibility Manual Eligibility Determinations

For an applicant/beneficiary who entered the facility on or after September 30, 1989, and has a spouse in the community, refer to I-1660 Spousal Impoverishment Resource Provisions (LTC/HCBS).

Compare the total countable resources to the resource limit for an individual (or couple). Refer to Z-900 Resource Limits by Program .

If the countable resources are greater than the resource limit, the applicant/beneficiary is resource ineligible for LTC.

If the countable resources are equal to or less than the resource limit, the applicant/beneficiary is resource eligible for LTC.

If the resources of a couple are greater than the couple resource limit, consider eligibility for each member of the couple as an individual.

Note: If considered as an individual for resource purposes, the applicant/beneficiary shall also be considered as an individual for income purposes.

H-831.5 Eligibility Determination

Evaluate all eligibility requirements and verification received to make the eligibility determination.

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).