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

not currently being received or expected to be received in the current or future months will not be counted. If a continuing source of income has increased or decreased since the last tax return or from other information available to the agency, the current income will be determined and used for eligibility purposes.  NOTE: Income received in a month for which retroactive eligibility is being determined will be considered for the retroactive month even if it is not considered for current or future months.

Once the household members’ current income has been established and verified using the ten percent (10%) reasonable compatibility standard as appropriate (See MS G-151-152), the monthly amount used to determine eligibility will be calculated. Depending on how the current income was established (e.g., tax return income via the Federal Data Services Hub, State Quarterly Wage Data, check stubs, SOLQ, etc.), the “verified” income amount may have to be reduced or increased to reflect a monthly amount. For example, if the most recent tax return reflects the income still currently available to the individual, the annual income from the tax return will be divided by 12 to arrive at a monthly amount. If the current income was established through the most recent weekly check stubs, the average weekly amount will be multiplied by 4.334 to arrive at a monthly amount. Unless the verified amount is already a monthly amount, for example Social Security benefits, then some conversion to a monthly amount is required. The calculation will be documented in the individual’s case file. The chart below shows how income amounts larger or smaller than monthly amounts can be converted to a monthly amount.

Income Amount is Convert to Monthly Annual Divide by 12 Quarterly Divide by 3 Weekly Multiply by 4.334 Bi-weekly Multiply by 2.167 Semi-Monthly Multiply by 2 Monthly No conversion needed More Often than Weekly Total all Income Paid/Received in the Month

Some situations require alternative methods to arrive at a current monthly income. For example, if annual income included a lump sum payment that will not be paid again, then the lump sum payment will be excluded from the rest of the annual income before the conversion E 265 Determining Current Gross Monthly Income for the Families and Individuals Groups