Page 43

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 11, 2025

Page 43 of I-1530 Replacing February 17, 2025

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

• LTC and LTC/HCBS Spend-down MNP patient liability determinations.

Deduct the verified monthly premium amount paid by the applicant/beneficiary:

Note: The premium must be paid by the applicant/beneficiary. It may NOT be paid by the community spouse (i.e. deducted from spouse’s earned/unearned income) or other third party.

• Medicare (shall be deducted first),

• Medical insurance, and

• Medical transportation insurance.

• LTC Partnership Insurance

Note: In patient liability determinations, medical insurance premiums that are paid quarterly, annually, etc. may be prorated monthly. For Medically Needy LTC, refer to H-1011.5 Bills Allowed in the Spend- Down Process.

Allowable medical insurance policies are those that relate payment to the amount of expense incurred by paying either actual charges or actual charges less a percentage.

Verify the monthly amount of medical transportation and medical insurance premiums at application and renewal.

If the applicant/beneficiary does not provide adequate verification, attempt to verify the premium by contacting the insurance company or agent.

Do not allow a deduction if the premium amount cannot be verified or the time period the premium covers cannot be determined.

A canceled check is not adequate verification.

Do not allow deductions for premiums for:

• Income replacement policies,