Program Description
Louisiana Medicaid helps seniors by providing personal care services to assist them with their Activities of Daily Living (ADLs) — such as bathing, grooming, transferring, and mobility — through the Long Term Personal Care Services (LT-PCS) program. Unlike the Louisiana Home and Community Based Services (HCBS) waivers, such as the Community Choices Waiver, this program does not have a waiting list, as it is part of the state Medicaid plan. (The state Medicaid program is an entitlement, meaning anyone who is eligible is able to receive services. On the other hand, Medicaid Waivers are not entitlement programs, which means there may be wait lists to receive services).
In addition to assistance with ADLs, also included is assistance with the Instrumental Activities of Daily Living (IADLs), such as food preparation, medication reminders, and transportation. This program is designed to allow seniors to remain living in their homes or to “age in place,” even though they are qualified to receive nursing home care. Medical / skilled care services are not included in this program, nor is around the clock care.
Eligibility Guidelines
General Requirements
To be eligible for the LT-PCS program, an individual must meet the following requirements:
- Be a resident of Louisiana.
- Be 65 years of age or older; OR 21+ and disabled.
- Need nursing-home level care.
- Must need assistance with a minimum of one daily living activity, such as bathing, grooming, dressing, or eating.
- Reside in a nursing home and be able to be discharged with appropriate assistance; OR be expected to require nursing home admission sometime in the next 4 months; OR have a primary caregiver who is either disabled or is a minimum of 70 years old.
- Be willing to live at home instead of in a nursing home.
- Have the capacity to direct their care, or have a representative who can assist with care management.
Financial Requirements
In addition to the functional requirements, candidates must meet the financial eligibility criteria for Louisiana Medicaid.
Income Limit
The monthly income limit for seniors is equivalent to the current SSI limit / Federal Benefit Rate. For 2023, this means an individual cannot receive an excess of $914 per month. For married applicants (regardless of whether both spouses are applying), the income limit is $1,371.
Asset Limit
There is also an asset limit. As of 2023, a single applicant is allowed $2,000 in assets, while married applicants are allowed $3,000.
Over the Financial Limits?
Louisiana has a Medically Needy Program (MNP), commonly called a spend-down program, which can be thought of as similar to a deductible. In basic terms, persons who have income in excess of the limit can “spend down” their income to meet the limit. Excess income can only be spent on specific expenses, such as medical and care costs.
Louisiana residents who cannot afford their cost of care but still cannot qualify for financial reasons might consider working with a Medicaid planner. These professionals help families qualify by re-allocating their resources so they aren’t counted toward the asset limit. In addition, Louisiana Medicaid allows certain exemptions for things like the individual’s primary home (valued up to $688,000 in equity in 2023), burial plots, and final expense insurance.
WarningPast asset transfers for five years prior to the date of application are eligible for review by Medicaid. This is to make sure the applicant did not give away or transfer assets under market value with the goal of qualifying for this program. This is called the Medicaid Look-Back Period, and if one is found to be in violation of this rule, a period of Medicaid ineligibility may result.
Benefits and Services
The following benefits are available via the Long Term – Personal Care Services program:
- Bathing and Toileting
- Coordination (Accompanying) of Medical Appointments
- Dressing and Grooming
- Food Preparation, Meal Storage, and Assistance Eating
- Grocery Shopping
- Laundry
- Light Housekeeping
- Prescription Supervision
- Mobility and Transferring
- Non-Medical Transportation – not a required program service, but care providers may provide this service
A couple points worth making about these services are that they are only available for the benefit of the program participant. If that person resides with another non-Medicaid housemate, services such as housekeeping and meal preparation are only for the program participant. Second, while medical services are not provided under this waiver, participants can receive those services under other Medicaid programs concurrently.
How to Apply / Learn More
This program is available in all Louisiana counties and is administered by the Office of Aging and Adult Services. To learn more or apply, one can call Louisiana Options in Long Term Care at 877-456-1146. A helpline at the Office of Aging and Adult Services is also available at 866-758-5035.
Limited information about this program is also available here and here.
