Page 22

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 22 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**”  Aged;

 Blind; or

 Disabled.

Refer to E-0000 Category.

H-851.3 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  Residence

I-1900

H-851.4 Establish Need

A. Determine Composition of the Income Unit

The income unit consists of:

 The applicant/beneficiary

B. Determine Need/Income

The applicant/beneficiary must have gross income which is equal to or below the SIL to be eligible for ACH Medicaid.

Note: Exclude any income received from VA Pension for Aid and Attendance from the gross income computation.

Add the gross earned and the gross unearned income and compare the total to the individual SIL.