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Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued May 16, 2022

Page 6 of H-1620 Revised/added text indicated by underscore

Deleted text indicated by “**”

Step 4 Add these remaining resources to the Community Spouses separate resources, Step 5 This sum is the Adjusted Countable Couple Resources, Step 6 Deduct the Spousal Impoverishment Resource

Standard (based on the first continuous period of LTC

services), Step 7 Compare the amount to the SSI Individual Resource

Limit ($2,000) to determine if the applicant/beneficiary

receiving LTC services is resource eligible.

I-1629 RESOURCES TRANSFERRED TO COMMUNITY SPOUSE

The following steps should be used when determining the amount of resources that may be allocated to the community spouse under the Spousal Impoverishment Resource Provision above for allocating resources. Step 1 Determine the Adjusted Countable Couple Resources Step 2 Deduct the Community Spouses Separate Resources Step 3 Deduct the SSI Individual Resource Limit Step 4 The remaining resources have to be transferred to the

community spouse prior to the first renewal. If the community spouse, who is not a LTCP policyholder, applies for LTC or HCBS, Medicaid eligibility for the spouse shall be determined using the standard Medicaid rules. Consequently, only the LTCP policyholder’s portion of resources will be disregarded and protected. The remaining unprotected resources will be considered available to the non-Partnership spouse for purposes of determining Medicaid eligibility.

Example: Mr. Jones is married and has a community spouse. Mr. Jones entered a nursing facility and is applying for Medicaid. The Jones’ have the combined total of countable resources of $250,000. Mr. Jones’ LTCP policy has paid $200,000 of benefits on his behalf. The adjusted countable resources of $50,000 is less than the spousal resource standard so the countable resources are $0, which is less than the $2,000 resource limit. For Mr. Jones to remain eligible for Medicaid, $50,000 adjusted countable couple resources minus