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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued March 18, 2025 Replacing March 5, 2024 Page 5 of I-1660 Revised/added text indicated by underscore Deleted text indicated by “”

Combined countable couple assets which are considered to be the total assets of the institutionalized spouse include separate resources of the community spouse, separate resources of the institutionalized spouse and shared assets of the couple. Refer to Section I of the LTC Spousal Resources Assessment/Worksheet (Form 4 LTC/SP-R)

Step 1. Determine the total countable separate resources of the community spouse. Do not count shared resources.

Step 2. Determine the total countable separate resources of the institutionalized spouse. Do not count shared resources.

Step 3. Determine the total countable shared resources of the couple. Do not include separate resources.

Step 4. Combine sums from Step 1, Step 2, and Step 3. The total is considered countable couple assets.

Step 5. Subtract the appropriate spousal impoverishment maximum protected resource amount from countable couple resources to determine the countable resources of the LTC/HCBS/ACH institutionalized spouse. Refer to Z-800 Spousal Impoverishment Maintenance Needs and Resource Standards.

Compare the institutionalized spouse's countable resources to the SSI individual resource limit.

When remaining resources are equal to or below the SSI individual resource limit, the institutionalized spouse is eligible. When remaining resources are above the SSI individual resource limit, the individual is not eligible.

If the institutionalized spouse is ineligible the couple shall be notified of the decision and the right to appeal.

If the institutionalized spouse is eligible based on the provisions for allocating resources to the community spouse, inform the couple that resources allocated to the community spouse must be transferred to the community spouse to remain eligible and that they will be allowed until the first renewal to effect the transfer.