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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 6 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**”  Assignment of Third Party Rights I-200  Citizenship/Identity and Qualified Non-Citizen Status I-300  Enumeration I-600  Medical Certification I-1000  Residence I-1900  Support Enforcement Services (SES) I-2000  Creditable Health Insurance I-2200

H-821.4 Establish Need Household composition continues to include those of the existing case for the month of admission and three (3) additional months.

Institutionalized Children under age 19 and Pregnant Women

Beginning with the fourth month through the sixth month, for institutionalized children under age 19 and pregnant women, determine eligibility for MAGI-based LTC. The income unit consists of only the institutionalized individual.

Remove the institutionalized individual from the existing MAGI-based certification and certify the individual in MAGI-based LTC. If the individual remains institutionalized more than six months, determine eligibility in Non-MAGI LTC. Institutionalized Parents/Caretaker Relatives

Beginning the fourth month for parents/caretaker relatives who remain institutionalized, remove the institutionalized individual from the existing MAGI-based certification and determine their eligibility in Non- MAGI LTC (e.g. aged, blind, or disabled). Refer to H-830 Non-MAGI Long Term Care.

H-821.5 Eligibility Decision

Evaluate all categorical and eligibility requirements and verification received to make the eligibility decision to reject or certify.

H-821.6 Determine Patient Liability There is no patient liability for an individual who is eligible for MAGI- based LTC.