Page 136

Title 8: Medicaid Page 132 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Non-MAGI-Related Coverage Groups Revised October 10, 2025 Medicaid for Kids with Special Needs (MKSN)  After the information is received, make the referral for a disability determination to DDS. When the child has not been determined to be disabled by the Social Security Administration, the Department must complete the disability determination process. See the Disability Determination Checklist, RC–0103, and procedures in 8-C, When the Department Determines Disability for instructions on making the referral. Family Income Limits Legal reference: 441 IAC 75 (Rules in Process) Policy: “Family” includes the MKSN child and family members who live with the MKSN child and who are not on full Medicaid under another case. Family members include:  The parents of the MKSN unmarried child, including stepparents.  All siblings under 19 and unmarried.  Any children of the MKSN child.  The spouse of the MKSN child.  Any children of the MKSN child’s spouse. Follow non-MAGI-related income policy to determine income. If the MKSN child is married, do not count the parents’ income. Monthly income limits are:

Household Size 300% of Poverty Household Size 300% of Poverty 1 $3,913 5 $9,413 2 $5,288 6 $10,788 3 $6,663 7 $12,163 4 $8,038 8 $13,538 If the family size is over 8, add $1,345 for each additional member. Health Insurance Enrollment Legal reference: 441 IAC 75 (Rules in Process) Policy: As a condition of eligibility for the MKSN coverage group, a parent must enroll the child in the parent’s employer group health insurance plan when the employer contributes at least 50% of the total cost of annual premiums.