Page 61

Title 8: Medicaid Page 57 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised October 10, 2025 Household Size Household Size Legal reference: 20 CFR 416.1160, 416.1163, 416.1166, and 416.1202; 441 IAC 75 (Rules in Process) For non-MAGI-related Medicaid purposes, a person is always treated as an individual, unless the person has a spouse who is also an eligible person. In that case, treat the person and the spouse as a couple. EXCEPTION: For the Medicaid for Employed People with Disabilities (MEPD) coverage group, determine countable income based on “family size.” Family size is determined as follows:  If the disabled person is under age 18 and unmarried, include parents, unmarried siblings under age 18, and children of the person who live with the person.  If the disabled person is aged 18 or older, or is married, include the person’s spouse and any children of the person or of the person’s spouse who are living with the person, under age 18, and unmarried. There may be situations where income is deemed to a non-MAGI-related eligible person from an ineligible spouse or parent. Also, in some instances when deeming from an ineligible spouse, an eligible spouse’s income should be compared to the income limits for a couple. See 8-E, Deeming Non-MAGI-Related Income. When a non-MAGI-related person is living with a spouse, consider the resources of the spouse (whether an ineligible or eligible spouse) and compare the couple’s total resources to the resource limit for a couple. See 8-D, Non-MAGI-Related Resource Limits.

1. Child A is disabled and lives with his parents and a sibling, Child B, who is also disabled. To determine Child A’s eligibility, his income and resources are compared to the eligibility limits for an individual (although income and resources from his parents may be deemed to him). Child B is also treated as an individual. 2. Mr. L, who is disabled, lives with Child D, who is also disabled. Mr. L’s eligibility is determined by comparing his income and resources to limits for an individual. Child D’s eligibility is also determined by comparing his income and resources (including any deemed income or resources) to the limits for an individual.