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Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 11, 2025

Page 1 of I-1530 Replacing February 17, 2025

Deleted text indicated by “” Revised/added text indicated by underscore

I-1530 NEED – SSI-RELATED INCOME

I-1531 INCOME UNIT

The income unit is the individual or group of individuals whose income must be considered in determining eligibility.

The income unit must include the:

• Applicant/beneficiary,

• Spouse living in the home, except in LTC and HCBS programs, and

• Parent(s) living in the home, when the applicant is a minor.

Exception: If a child is an intellectually or developmentally disabled applicant coming from a non-institutionalized setting, include the parent(s) living in the home in the income unit the first calendar month of Medicaid approved participation only. Refer to H-900 Home and Community Based Services.

If the applicant lives with a spouse who is an SSI beneficiary, include the SSI beneficiary in the income unit but do not count the beneficiary's SSI income.

I-1532 POTENTIAL INCOME (Applying for Other Benefits)

If the applicant/beneficiary is eligible for other benefits, s/he must apply for and accept those benefits.

Count as though received any benefits for which the applicant/beneficiary may be entitled but refuses to apply for or receive, except when the individual presents evidence of good cause.

Consider each request for a good cause exception. Good cause is present when:

• The applicant/beneficiary is mentally or physically incapable of filing for benefits and does not have an authorized representative to act on their behalf,

• Death or serious illness in the applicant/beneficiary’s family,