Medicaid for nursing home and home care in Louisiana

Who qualifies

You must live in Louisiana, be 65 or older, blind or disabled, and need nursing home level of care. The state's Office of Aging and Adult Services (OAAS) decides the level of care. For a nursing home stay, you must be likely to stay at least 30 days in a row.

The income limit is three times the federal SSI payment. LDH compares your gross income, before anything is taken out, to this limit. VA Aid and Attendance is not counted.

What counts and what does not

Assets that count: cash, bank accounts, CDs, stocks, bonds and other property you could turn into cash.

Assets that usually do not count: your home (if your equity is under the limit), one car, household goods, burial plots, and some life insurance and burial funds. LDH follows the SSI rules for most of these.

Gifts and transfers. LDH looks back 60 months at money or property you gave away or sold for less than it was worth, and at trusts. A transfer can lead to a penalty period when Medicaid will not pay the nursing home, even though you may still have Medicaid for other care.

Asset check. Everyone applying in the aged, blind or disabled groups must sign an asset verification form. LDH uses it to check your bank records electronically. A spouse must sign too. Coverage ends without it.

If your income is over the limit: spend-down

If you live in a nursing home and your income is over $2,982, you may get coverage through Long-Term Care Spend-Down Medically Needy.

• LDH subtracts a few amounts from your income, including the first $20 and your health insurance premiums, and the Medically Needy standard ($100 or $92 a month, by parish).
• What is left is your "excess income." Your medical bills, including the projected Medicaid rate for your nursing home, must equal or pass that amount.
• If they do, Medicaid can start on the first day of the month. Coverage is approved for up to 12 months, with a review every 6 months.

What you pay each month

Once you qualify, most of your income goes to the nursing home. This is called your patient liability. You keep:

• A personal needs allowance of $45 a month for clothing, haircuts and other personal items.
• Money for your health insurance premiums and some other medical costs.
• An allowance for your spouse at home, if you are married (see below).

On a home care waiver, you keep up to three times the SSI payment for your living costs.

If you are married

When one spouse needs long-term care, Louisiana protects the spouse who stays at home:

• Assets: The spouse at home can keep up to $162,660 in countable assets (for care starting in 2026).
• Income: If the spouse at home has little income, part of your income can go to them so they reach up to $4,066.50 a month.

Programs that pay for care

Nursing facility care

Medicaid pays for 24-hour skilled nursing and help with daily tasks. You can apply at the nursing home you choose, or call Louisiana Options in Long Term Care at 1-877-456-1146 for the medical approval (Form 142). You must move in within 30 days of that approval.

Community Choices Waiver

For people 21 and over who qualify for long-term care Medicaid and need nursing home level care. It pays for help with bathing and dressing, adult day health care, home-delivered meals (up to two a day), home changes such as ramps and grab bars, nursing, therapy, emergency response systems and respite for caregivers. It does not give 24-hour care. Most people get an offer first come, first served. Some go first, including people referred by protective services, people with ALS, and people in a nursing home where Medicaid pays.

Long-Term Personal Care Services (LT-PCS)

Help with bathing, dressing, eating, toileting and moving around, plus light housework, meals and shopping. You must have Medicaid, be 21 or older, qualify for nursing home care, and need help with at least one daily task.

PACE

For people 55 and over in certain areas who can live safely at home. One team provides all medical and long-term care.

How to apply

1. Call Louisiana Options in Long Term Care at 1-877-456-1146 (TTY 711). They screen you for level of care and the home care programs.
2. Apply for Medicaid. Use the Long Term Care Application on ldh.la.gov, apply on the Self-Service Portal (sspweb.lameds.ldh.la.gov/selfservice), call 1-888-342-6207, or visit a regional Medicaid office, Monday to Friday, 8 a.m. to 4:30 p.m.
3. Send proof of income, assets, age and citizenship. You get at least 10 days to send what is asked for.
4. Decision. Applications are generally decided within 45 days. If a disability decision is needed, LDH has up to 90 days.

After you apply

• Renewals: Long-term care coverage is usually approved for up to 12 months at a time.
• Report changes in income, assets or where you live.
• Appeals: File by the date on your notice. If you appeal within 10 days, your services keep going during the appeal. Send it to the Division of Administrative Law, Health and Hospitals Section, P.O. Box 4189, Baton Rouge, LA 70821-4189, fax 225-219-9823, or call 225-342-5800.
• Estate recovery: LDH may seek repayment from your estate for long-term care received after age 55, but not while your spouse is alive, or if you leave a child under 21 or a blind or disabled child.

Common mistakes

• Giving away money or a house in the 5 years before applying.
• Not applying because income is over the limit. The spend-down can still help in a nursing home.
• Not returning the asset verification form.

Free help

• Louisiana Options in Long Term Care: 1-877-456-1146.
• LaSHIP (Medicare counseling): 1-800-259-5300.
• Governor's Office of Elderly Affairs: (225) 342-7100, for your parish Council on Aging.

See all benefits in Louisiana and our guide to paying for a nursing home.

Phone numbers: Free help lines for Louisiana agencies

Check what you may qualify for