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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 21 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” H-850 ACUTE CARE HOSPITAL (ACH)

H-850.1 General Information

Medicaid coverage is available to Individuals institutionalized in an Acute Care Hospital for at least 30 consecutive days, whose income is equal to or below the Special Income Level (SIL) and whose resources are equal to or below the SSI limit.

Eligibility under the SIL is applicable to a period of institutionalization likely to continue at least 30 consecutive days. Refer to I-400 Continuity of Stay.

H-850.2 Special Income Level Income eligibility is based on the applicant/beneficiary's gross income, excluding Veterans Administration (VA) aid and attendance.

The applicant/beneficiary’s gross earned and unearned income is compared to the SIL rate. The SIL is three (3) times the monthly SSI Federal Benefit Rate (FBR) for an individual. The couple SIL is double the individual SIL. Refer to Z-700 LTC/HCBS/ACH SIL Rate, Resource Limits and Personal Care Needs Allowance.

H-850.3 Patient Liability

There is no patient liability (PLI) for an individual who is eligible for ACH.

H-851 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-851.1 Determine Assistance/Benefit Unit The assistance/benefit unit consists of the applicant/beneficiary.

H-851.2 Establish Categorical Requirement

Verify that the applicant/beneficiary is: