Page 19

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 19 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” the BHSF Form 142), only the applicant/beneficiary who is a minor 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 institutionalized individual.

D. Determine Need/Countable Resources Determine total countable resources of the applicant/beneficiary. Refer to I-1630 Need - SSI-Related Resources.

Transfer of resources or substantial home equity only applies to LTC vendor payment and does not apply to Medicaid coinsurance eligibility determination.

If the applicant/recipient entered the facility on or after September 30, 1989, and has a spouse living 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 Medicaid coinsurance.

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

If the resources of a couple are greater than the couple resource limit, consider eligibility for each 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-841.5 Eligibility Decision Evaluate all eligibility requirements and verification received to make the eligibility decision.

Note: Consider income eligibility in QMB or SLMB. Refer to H-1100