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Title 8: Medicaid Page 26 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Breast and Cervical Cancer Treatment Revised February 28, 2025 Case Maintenance

Mrs. C applies for Medicaid in April. She provides the verification that shows she is in need of treatment for breast cancer. However, the worker determines that Mrs. C is eligible for Medicaid under MAGI- related, because her 12-year-old son lives with her and she meets all other MAGI-related Medicaid eligibility criteria. In May, Mrs. C reports beginning income that results in her countable income exceeding the MAGI-related Medicaid limit for two people. The only coverage group other than BCCT under which Mrs. C can establish eligibility is Medically Needy with a spenddown. The worker asks Mrs. C to either provide verification that she is still under treatment for breast cancer or sign a release of information so that the worker can contact the medical provider. If Mrs. C is still under treatment, the worker establishes Medicaid eligibility under the BCCT coverage group. If Mrs. C is no longer receiving treatment for the breast cancer, eligibility should be considered under another coverage group. MAGI-Related Coverage Groups Legal reference: P. L. 104-193; 441 IAC 75 (Rules in Process) Medicaid eligibility policy for pregnant women, parents and other caretakers, and children is based on family-related medical assistance under MAGI. MAGI-related coverage groups include:  Family Medical Assistance Program (FMAP).  Ineligible for FMAP due to the receipt of support.  Transitional Medicaid.  Mothers and Children (MAC) program.  Medical institution 300% group.  Pregnant and postpartum women. See Pregnant or Postpartum Women and Deemed Newborns.  Deemed newborn children of Medicaid-eligible mothers. See Deemed Newborn Children of Medicaid-Eligible Mothers.  Iowa Health and Wellness Plan (IHAWP). NOTE: Refer to 8-H, Foster Care, Adoption and Guardianship Subsidy for specialized children coverage groups.