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Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued May 16, 2022

Page 2 of H-1620 Revised/added text indicated by underscore

Deleted text indicated by “**”

I-1623 DETERMINING IF A LTCP POLICY IS QUALIFIED

In order for a LTCP policy to be “qualified”, the policy must satisfy all relevant requirements of federal and state laws. The Louisiana Commissioner of Insurance is responsible for certifying that these policies are qualified. A listing of approved companies who can sell these policies can be found on the Louisiana Department of Insurance website.

Individuals who were a resident in another participating state who purchased qualifying policies are allowed to participate in the LTCP program if the policy was purchased when coverage first became effective under that State’s policy. A list of these participating states and start dates can be found at Reciprocating States.

A policy issued under a group insurance contract may be considered qualified if the certificate meets the requirements.

Policies issued prior to the LTCP program's effective date of October 1, 2009 are not considered a qualified policy. The policyholder may be entitled to exchange the existing non-qualified policy for a qualified policy. A policy received in an exchange on or after October 1, 2009, is treated as newly issued and is eligible for LTCP program status.

The applicant/beneficiary who owns an insurance policy that are not qualified as LTCP policies are not eligible to participate in the LTCP program and their resources cannot be disregarded in the Medicaid eligibility determination or protected from Estate Recovery.

I-1624 VERIFICATION NEEDED

Request a copy of the policy from the applicant/beneficiary. Verify with the Louisiana Department of Insurance that the insurance company is approved to sell these policies in Louisiana.

The applicant will be responsible for providing policy status changes (i.e. termination of coverage, change in ownership, termination of premiums).