Page 15
Louisiana Medicaid Eligibility Manual Eligibility Determinations
Reissued January 6, 2026 Page 15 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” H-831.7 Certification Period
The certification period cannot exceed 12 months beginning with the first month of eligibility.
H-831.8 Notice of Decision
Send the notice of decision to the applicant/beneficiary/authorized representative.
Send a copy of the decision notice to the facility.
H-831.9 Post Certification
Applicant/beneficiaries are required to apply for any annuity, pension, retirement, and disability benefits for which they are entitled. They should be encouraged, but not required to apply for SSI cash benefits.
H-840 MEDICAID COINSURANCE—MEDICARE SNF H-840.1 General Information
Original Medicare Part A covers skilled nursing facility (SNF) care provided to an applicant/beneficiary on a short-term basis if the following conditions are met. The applicant/beneficiary:
● Has Medicare Part A;
● Has a 3-day qualifying hospital stay; and
Receives skilled nursing facility (SNF) services.
Original Medicare Part A covers SNF care for up to a total of 100 days per Medicare benefit period:
● Days 1 – 20: Medicare pays the full cost. Medicaid has no responsibility for payment.
● Days 21 – 100: Medicare pays all but the daily coinsurance. Medicaid may assist with payment of the daily coinsurance.
Medicare is a third party payor and is billed first in this situation. Medicaid is the payor of last resort.
When the reimbursement from Medicare exceeds the maximum