Page 50

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued August 11, 2025

Page 50 of I-1530 Replacing February 17, 2025

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

Note: The reduction of the VA Improved Pension to a maximum of $90 is protected as the personal care needs allowance. Allow the $90 PCN when the VA actually reduces the pension to $90.

Step 5. Deduct maintenance needs of the community spouse

Step 6. Deduct maintenance needs of dependents living in the home prior to admission. Refer to I-1536 Deductions.

Step 7. Subtract all allowable medical insurance premiums and other allowable medical bills. Refer to I-1536 Deductions.

Step 8. The remainder is the patient liability owed by the applicant/beneficiary for their cost of care. This is the projected PLI.

PLI Steps for ICF (Group Homes)

Step 1. Determine the total unearned income.

Include all VA Pension including Aid and Attendance payments.

Step 2. Determine the total gross earned income.

a) Subtract $65 earned income disregard, and b) Subtract one-half of the remainder.

The remaining amount is the countable earned income.

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.

Note: The reduction of the VA Improved Pension to a maximum of $90 is protected as the personal care needs allowance. Allow the $90 PCN when the VA actually reduces the pension to $90.