Page 16

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued June 1, 2026

Page 16 of H-900 Replacing June 08, 2021 Revised/added text indicated by underscore

Deleted text indicated by “” by Program.

Note: If eligibility for HCBS is established for a couple using the couple SIL, but the couple’s resources exceeds the $3,000 couple resource limit, eligibility as a couple is not met. Re-evaluate the eligibility as an individual for each member using the individual SIL and resource limit.

If resources are greater than the resource limit, the applicant/beneficiary is resource ineligible for HCBS. If resources are equal to or less than the resource limit, the applicant/beneficiary is resource eligible for HCBS.

H-921.5 Eligibility Decision

Evaluate all eligibility requirements and verification received to make the eligibility decision.

H-921.6 Reserved

H-921.7 Certification Period

The certification period cannot exceed twelve (12) months.

Children certified for the CSoC-SED waiver are eligible for twelve (12) months continuous eligibility for regular Medicaid services.

H-921.8 Notice of Decision

Send notice of decision to the applicant/beneficiary.

Send a copy of the decision notice to OAAS or OCDD regional office and the specified support coordinator for: • ADHC; • OAAS-CCW; • OCDD-CC; • NOW; • ROW; or • SW.