Page 23

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 23 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” If the total gross income is greater than the SIL, the applicant/beneficiary is income ineligible.

If the total gross income is equal to or less than the SIL, the applicant/beneficiary is income eligible. Continue the determination of need.

C. Determine Composition of the Resource Unit The resource unit consists of:

 The applicant/beneficiary; or

 The applicant/beneficiary and the community spouse;

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 ACH eligibility determinations.

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/ACH).

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 Acute Care Hospital coverage.

H-851.5 Eligibility Decision Evaluate all eligibility requirements and verification received to make the eligibility decision.