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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 16 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” allowable by Medicaid, Medicaid will make an approved payment of $0.00. This claim is considered payment in full and the provider may not seek payment from the applicant/beneficiary.

Applicant/beneficiary income shall not be considered in determining vendor payments for a period of up to 100 days provided he/she remains eligible for Medicare. This also includes the period for which coinsurance is being paid by the Medicaid Program. Refer to LAC 50:II.10147(B).

H-841 ELIGIBILITY DETERMINATION PROCESS Determine eligibility by applying the following criteria. The elements have been listed in the most logical order, but work on all steps simultaneously.

H-841.1 Determine Assistance/Benefit Unit The assistance/benefit unit consists of the applicant/beneficiary.

H-841.2 Establish Categorical Requirement

Verify that the applicant/beneficiary is:

● Aged;

● Blind; or

● Disabled.

Refer to E-0000 Category.

H-841.3 Establish NonFinancial- Eligibility Verify eligibility for the applicant/beneficiary with regard to the following factors:

 Assignment of Third Party Rights I-200  Citizenship/Identity and Qualified Non-Citizen Status I-300  Continuity of Stay

I-400  Enumeration

I-600  Medical Certification

I-1000