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Title 8: Medicaid Page 29 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups MAGI-Related Coverage Groups Revised February 28, 2025 People Who are Ineligible for FMAP To qualify, at least one member must have received FMAP in three of the six months immediately before the month of cancellation. Do not consider any month in which the assistance is subject to recoupment in this three-month calculation.

1. Mrs. K and her three children are canceled from FMAP effective June 1 due to receipt of alimony. They are eligible for extended Medicaid if they received FMAP in three of the previous six months. 2. Mrs. B and her two children are canceled from FMAP effective February 1, 2009, due to increased spousal support. The family received FMAP in August and September of 2008 and in January 2009. Mrs. B and her two children are eligible for the four months of extended Medicaid. Members may request cancellation of FMAP because they are receiving alimony or other spousal support directly. However, grant extended Medicaid only if the alimony or other spousal support exceeds the FMAP income limit.

A family receiving Medicaid under FMAP starts receiving spousal support directly on March 22 but does not report this to the IM worker until April 25. The spousal support is enough to cancel FMAP. Since the receipt of spousal support was not timely reported, extended Medicaid begins April 1. Had the spousal support been reported timely, FMAP cancellation would not be effective until May 1, allowing a ten-day notice. Extended Medicaid would begin May 1. Begin the four months of extended Medicaid with the month following the month the family became ineligible for FMAP due to receipt of alimony or other spousal support. During these four months, the family must continue to meet all FMAP eligibility requirements except income. If FMAP is reinstated but later lost again due to the receipt of alimony or other spousal support, begin a new four-month period if the family qualifies. Adding People to the Eligible Group Legal reference: 441 IAC 75 (Rules in Process) The extended Medicaid eligible group includes:  Every person who was in the FMAP eligible group in the last month FMAP was received.