Page 5

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued June 9, 2026

Page 5 of I-1630 Replacing September 23, 2024

Revised/added text indicated by underscore

Deleted text indicated by “**” resource unless all of the following criteria are met. The annuity:

1. Is irrevocable;

2. Pays out principal and interest in equal monthly installments (no balloon payment) to the individual in sufficient amounts that the principal is paid out within the actuarial life expectancy of the institutionalized individual,

3. Names the State of Louisiana, Louisiana Department of Health (LDH) or its successor agency as the primary and permanent residual beneficiary of funds remaining in the annuity, not to exceed any Medicaid funds expended on the individual during their lifetime, and

4. Is issued by an insurer or other body licensed and approved to do business in the jurisdiction in which the annuity is established.

Annuities which do not meet all of the above criteria must be amended to comply with these requirements. Annuities which do not provide for pay out of principal and interest in equal monthly installments and for which documentation is received from the issuing company that the “pay out” arrangements cannot be changed, will be considered to meet the new requirements once amended to name the State of Louisiana, Department of Health and Hospitals or its successor agency as the primary and permanent residual beneficiary of funds remaining in the annuity, not to exceed any Medicaid funds expended on the individual during their lifetime.

Note: The Department of Insurance web site can be used to determine if a company is licensed and approved to do business in LA. The site is www.ldi.state.la.us. Use the Industry Search feature, at Search Forms use Company Search Form. The name of the company is entered for the search.

Use Z-1200 Life Expectancy Tables to determine actuarial life expectancy of the annuitant when necessary.

Treatment of Annuities created on or after February 8, 2006

Effective February 8, 2006, all long term care applicants, including SSI beneficiaries, were required to disclose on their application