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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued January 6, 2026 Page 7 of H-800 Replacing August 11, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” H-821.7 Certification Period The certification period cannot exceed six (6) months for children under age 19 and pregnant women. If the applicant/beneficiary remains institutionalized for more than six (6) months determine their eligibility in Non-MAGI LTC.

The certification cannot exceed three (3) months for Parent Caretaker Relative (PCR).

H-821.8 Notice of Decision Send the notice of decision to the applicant/beneficiary and a copy to the facility.

H-821.9 Post Certification The applicant/beneficiary is required to apply for other benefits they are potentially eligible to receive. The applicant/beneficiary is not required to apply for SSI but should be encouraged to do so.

H-830 NON- MAGI LONG TERM CARE H-830.1 General Information

Applicants/beneficiaries residing in an LTC nursing facility may be certified for Non-MAGI LTC.

Persons eligible in the Non-MAGI LTC program fall into these groups:

● Those who are eligible for SSI at the time of admission;

● Those who are not certified for SSI but meet all eligibility criteria;

● Those who are not income eligible for SSI in the community, but have income equal to or below the SIL; or

● Those whose income is above the SIL, but have enough incurred medical expenses to spend-down their excess income. A vendor payment will be made if the post-eligibility process results in a PLI below the facility fee.

● Those who are expected to be continuously institutionalized in an Acute Care Hospital (ACH) for at least thirty (30) Days (e.g., a Hospital or Rehabilitation Center) with income equal to or