Page 18

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 18 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” of need.

Couples in the Same Facility

Beginning with the month that both the applicant 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.

If the applicants/beneficiaries are a couple, use the couple SIL.

If the 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.

If the combined gross income of the couple exceeds the couple SIL, the couple is income ineligible. Re-evaluate the eligibility of each 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 have income above the individual SIL, determine eligibility in the Spend down MNP. Refer to H-1030 Spend-Down Medically Needy - SSI-Related.

If need is considered for the applicants/beneficiaries as a couple, consider eligibility for QMB/SLMB using couple QMB/SLMB limit.

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 (the month of eligibility listed on