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Title 8: Medicaid Page 28 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups MAGI-Related Coverage Groups Revised February 28, 2025 Family Medical Assistance Program (FMAP) NOTE: Medicaid is not linked to FIP. Therefore, it is possible to be ineligible for FIP and still be eligible for Medicaid benefits or to be eligible for FIP and ineligible for Medicaid. Do not consider this coverage group for: Children who do not live with a parent or other caretaker. Children age 18 (unless they are attending school). Adults who are not a parent or other caretaker. Pregnant women with no children other than the unborn child. Adults who do not live with a child and assume primary responsibility for the care of a child.
1. Ms. L applies for Medicaid for herself and her two-year-old son. She has no income. Since Ms. L and her son meet the financial eligibility factors, both are eligible for Medicaid under the FMAP coverage group. 2. Mr. and Mrs. Z and their two children apply for Medicaid. Mr. and Mrs. Z are filing taxes jointly and claiming both children. Both Mr. and Mrs. Z are employed, but their countable income is less than the FMAP limit for a four- member household. The Z family is eligible for FMAP if all other eligibility factors are met. 3. Mr. P is a caretaker of his five-year old neighbor who is currently living with him. If all other eligibility factors are met, Mr. P and his five-year-old neighbor are eligible for FMAP. People Who are Ineligible for FMAP Medicaid benefits are available to people who are ineligible for FMAP due to: Receipt of alimony or other spousal support (extended Medicaid), or Increased income from employment (transitional Medicaid), or Being a resident in a medical institution. Ineligible Due to Receipt of Support (Extended Medicaid) Legal reference: 42 CFR 435.115; 441 IAC 75 (Rules in Process) Medicaid continues up to four months to persons and families ineligible for FMAP in whole or in part because of alimony or other spousal support.