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Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued May 16, 2022

Page 5 of H-1620 Revised/added text indicated by underscore

Deleted text indicated by “**”

Example: Joe applies for Medicaid and his LTCP policy has paid out $100,000. Joe is found eligible using his disregard of resources. A few months later, Joe reports he has given $100,000 to his son. Because he has given away no more than the $100,000 protected asset amount, there is no transfer penalty. However, because he has divested the entire payout amount, he can no longer take advantage of the LTCP protections with regard to his Medicaid eligibility. That means he must have assets below $2,000 to remain eligible (instead of $102,000). Since he already gave away the entire protected amount during his lifetime, that amount will not be protected from estate recovery.

I-1627 TREATMENT OF SUBSTANTIAL HOME EQUITY

The LTCP resource disregard cannot be applied to excess home equity value. If an applicant/beneficiary’s equity value in their home property exceeds limit in effect at time of application (Refer to MEM Z-2300), and the exceptions or undue hardship does not apply, the applicant/beneficiary is not eligible for LTC services of vendor payment to the nursing facility, HCBS, or PACE.

I-1628 TREATMENT OF RESOURCES - SPOUSAL RESOURCE ELIGIBILITY DETERMINATION

The resource disregard can only apply to the resources owned by the applicant/beneficiary receiving LTC services who is the policyholder/beneficiary and not to resources owned separately by the community spouse. Jointly owned resources are considered as belonging to the applicant.

The following steps will be used when resource eligibility is being reviewed under the Spousal Impoverishment Resource Provision for allocating resources: Step 1 Determine the applicant’s total countable resources

for the most recent continuous period of LTC services, Step 2 Deduct the dollar amount of paid insurance benefits the applicant/beneficiary receiving LTC services received from the qualifying policy, Step 3 This remainder is the applicant’s remaining resources,