Page 44

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 11, 2025

Page 44 of I-1530 Replacing February 17, 2025

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

• Accidental death and dismemberment policies, or

• Sick and accident policies.

Evaluate policies with combined coverage (i.e., those that provide medical insurance and income replacement) to determine whether the premium for the income replacement provision can be determined separately.

If the premiums can be determined separately, deduct the medical insurance portion of the premium.

If the premiums cannot be determined separately but the majority (over 50%) of policy provisions is allowable, deduct the total premium.

Maintenance Needs Allowance for Legal Dependents

For long term care facility patient liability determinations involving Spousal Impoverishment Provisions only deduct the allowance for legal dependents of a long term facility care applicant/beneficiary living with a long term facility care community spouse. Refer to I-1537.3, Maintenance Needs

For long term care facility patient liability determinations involving an individual with legal dependents and no community spouse, deduct the MNIES for the number of dependents. Refer to I-1537.3, Maintenance Needs

For HCBS Spend-down MNP patient liability determinations involving an individual with legal dependents with or without a community spouse, deduct the monthly MNIES for the number of dependents.

Maintenance Needs Allowance for Community Spouse

For long term care facility patient liability determinations involving Spousal Impoverishment Provisions only deduct the allowance for a long term care facility community spouse. Refer to I-1537.3, Maintenance Needs

For HCBS Spend-down MNP patient liability determinations involving Spousal Impoverishment Provisions deduct the allowance for a long term care community spouse.