Page 45

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 11, 2025

Page 45 of I-1530 Replacing February 17, 2025

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

Personal Care Needs

For long term care facility patient liability determinations only, deduct a standard allowance to help cover the cost of personal care items not covered by the facility fee.

Note: The $90.00 VA Improved Pension may not be used to reduce the Medicaid payment to the facility and does not replace the PCN.

Refer to Z-700 LTC/HCBS SIL Rate, Resource Limits and Personal Care Needs Allowance.

SSI Standard Deduction

Do not apply this deduction to:

LTC categorically needy eligibility or patient liability determinations, or income based on need (e.g., AFDC payments, VA pensions).

For all other programs, including LTC/HCBS Spend-down MNP, deduct $20 from monthly income not based on need for each:

• Individual, or

• Couple.

Deduct the $20 from unearned income first. Then deduct any unused portion of the $20 from earned income.

I-1537 SPOUSAL IMPOVERISHMENT INCOME PROVISIONS

I-1537.1 General Information

Apply these provisions only in the LTC patient liability determination for an LTC/HCBS/ACH applicant/beneficiary who has a legal community spouse. The community spouse is the legal spouse of an institutionalized individual, who lives in a non-institutionalized setting. Spousal Impoverishment applies if the spouses are not residing in the same home due to medical reasons or due to circumstances beyond their control. A person receiving home and community based services is considered institutionalized for Medicaid purposes.