Page 49

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 11, 2025

Page 49 of I-1530 Replacing February 17, 2025

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

remaining after allowable deductions. PLI is projected for a three month period, beginning with the first month of Medicaid eligibility. Post-eligibility treatment of income (PETI) rules are used to calculate an applicant/beneficiary’s PLI for nursing home, Home and Community Based Waiver or ICF/IID services.

Allow deductions in the following order:

Deductions

1. Earned Income Deduction

2. Personal Care Maintenance Needs Allowance

3. Maintenance Needs of Community Spouse 4. Maintenance Needs of Family a. Legal Dependents Living with a Community Spouse b. Legal Dependents with no Community Spouse 5. Allowable Health Insurance Premiums, Deductibles, Co- Insurance Charges and Copayments 6. Allowable Medical Bills

PLI Steps for LTC, LTC SD MNP and HCBS SD MNP

Step 1. Determine the total unearned income.

For the month of entry to an institution or the month the individual converts from Medicare to Medicaid pay status include the entire SSI payment.

** Include all VA Pension including Aid and Attendance payments.

Step 2. Determine the total gross earned income. All earned income is counted.

Step 3. Add the countable earned and countable unearned income.

Step 4. Deduct the personal care maintenance needs allowance. Refer to Z-700 LTC/HCBS SIL Rate, Resource Limits and Personal Care Needs Allowance.