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Title 8: Medicaid Page 78 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised October 10, 2025 When the Department Determines Disability Procedure: To determine SGA for an employed person, calculate the person’s countable income by averaging gross income over the time the income was earned after the disability occurred. EXCEPTION: Do not consider the earned income limits under SGA for eligibility under the Medicaid for Employed People with Disabilities (MEPD) coverage group. Use the following procedure to determine if an employed client’s countable monthly income demonstrates SGA:

Step Action Determine average monthly earnings. Count earnings from employment and self-employment. Determine seasonal income by averaging income over the season to arrive at a monthly countable income. See 8-E, Income Policies for Non-MAGI-Related Coverage Groups. Determine excluded earnings. Do not count:  Earnings of volunteers under the Small Business and Domestic Volunteer Acts.  Employer subsidies to an impaired person that are not earned through the person’s productivity. Ask the employer to determine the subsidy. If the employer cannot calculate the subsidy, compare the work to similar work of an unimpaired person, and the value of that work by the prevailing wage scale. Determine deductions. Deduct work expenses related to the person’s disability. See 8-E, Deduction for Impairment-Related Work Expenses.