Page 133

MEDICAL SERVICES POLICY MANUAL,SECTION E E-200 Determining Financial Eligibility Under the MAGI Methodology

E-260 Determining Countable Income for Families and Individuals Groups MS Manual 08/03/2020 Once the Medicaid household composition has been established for the individual, each householdmember’s countable incomemust be determined. Only the income ofpersons in an individual’s Medicaid household is considered when determining financial eligibility.

Countable income sources using the MAGI methodology are the same as a tax filing unit’s taxable income sources with a few exceptions. The exceptions are: • Social Security benefits are counted in full. • Income received as a lump sum is counted as income only in the month received. • Any portion of an educational scholarship, award or fellowship grant used forliving expenses is countable income.

E-261 Income Included for Families and Individual Groups MS Manual 08/03/2020 Although not an exhaustive list, the following are examples of taxable income included in MAGI calculations to determine Medicaid eligibility: 1. Earned Income: If the pay stub lists “Federal Taxable Wages” use that amount; if not, use “Gross Income” instead; 2. Self-employment income or “Net Self-Employment income”: The amount after allowable income- producing costs are deducted. See MS E-266; 3. Social Security Income (Title II) – counted in full for Medicaid even though only a portion (or none) may be taxable; 4. Lump sum payments in month of receipt only; 5. Dividends and interest income; 6. Unemployment compensation; 7. Alimony, divorces, and separations finalized before January 1, 2019; 8. Pensions and annuities payments; 9. Rental income; 10. Lottery and gambling winnings (Income less than $80,000 is countable income in month received. Income greater than or equal to $80,000 to $89,999 is countable income for two months, divided equally. For every additional $10,000, add a month and divide equally. The maximum penalty cannot exceed 120 months or 10 years. Pro- E 260 Determining Countable Income for Families and Individuals Groups