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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 4 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” H-810.5 Categories F (06), V (22), I (08), and O (15) The Department of Children and Family Services (DCFS) is responsible for determining eligibility for LTC and patient liability for children in state custody who are certified in Categories F, V, I, and O. H-810.6 Incurred Medical Expense Deduction

A deduction for incurred medical expenses (IME) may be allowed in the LTC post-eligibility PLI determination. Refer to I-1536 Deductions. H-820 MAGI-BASED LONG-TERM CARE H-820.1 General Information

Applicants/beneficiaries residing in a long-term care (LTC) facility may be certified for MAGI-based LTC.

Individuals eligible for MAGI-based LTC fall into these groups:

● Individuals whose Medicaid eligibility has already been determined using MAGI-based rules and are certified for Parent and Caretaker Relatives Group, Children Under Age 19 Group, or Pregnant Women Group or Regular Medically Needy (MNP) at the time of admission to the facility.

Note: Individuals whose eligibility has or has not been established in the Adult Group cannot be considered for MAGI-based LTC. Eligibility must be considered for Non-MAGI LTC.

Note: Temporary absence policy allows for a temporary absence from the household for up to 90 days with continued Medicaid eligibility.

● Individuals whose Medicaid eligibility has not been determined using MAGI-based rules, but would be eligible in Parent and Caretaker Relatives Group, Children Under Age 19 Group, or Pregnant Women Group or Regular Medically Needy (MNP) had they applied prior to admission to the facility.