Page 20

Louisiana Medicaid Eligibility Manual Eligibility Factors

Reissued October 21, 2025 Page 20 of I-1670 Replacing January 27, 2025 Revised/added text indicated by underscore Deleted text indicated by “**” based on:

o The frequency and duration; or

o The usual and customary charges, if purchased from an outside source in that community.

If the service is transportation for shopping, visits to the doctor, etc., the value may be based on the local taxi fare charges. If the services are to be provided for the life of the individual, the total value is determined by using the Life Expectancy Table to determine the total value. Refer to Z-1200 Life Expectancy Tables.

Multiply the yearly fair market value of the services by the figure in the "Average Years of Life Remaining" column, which corresponds to the age of the individual as of last birthday at the time the asset was transferred.

When compensation is made in the form of a service, the person who received the transferred asset must provide some verification such as:

• A written statement describing the service he or she agreed to perform; and

• The frequency and duration of such services.

If the services are to be provided on an as needed basis, the statement must include:

• The expectations as to the frequency of the services;

• A description of the agreement concerning compensation for services reached between the provider of the service; and

• The basis for that expectation.

Verification of Value of Real Property Transferred Within the Sixty Month Lookback Period

Verify the value in at least one of the following ways:

• By obtaining copies of the act of sale in the conveyance records, offer of sale, mortgage, judgement, or other documentary evidence dated less than one year from the