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Title 8: Medicaid Page 30 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  Every person whose needs and income were included in determining the household’s eligibility when FMAP benefits were terminated. Also add the following people to the eligible extended Medicaid group:  People returning to the home whose needs and income would be taken into account in determining the FMAP eligibility if the household were applying in the current month.  Dependent children returning home from foster care, if they would have been included if at home while the household was on FMAP.  People who were not included in the FMAP eligible group because they were receiving SSI, if they have since lost SSI.  People who were not included in the eligible group, such as a child in deemed newborn status. If an adult is a mandatory member of the eligible group and is not eligible for Medicaid (ineligible adult alien, sanctioned adult, etc.), the adult remains a member of the eligible group as a “considered” person. Transitional Medicaid Legal reference: P. L. 100-485, 441 IAC 75 (Rules in Process) Transitional Medicaid is available to individuals who receive FMAP and who are no longer eligible due to:  Increased earned income of the dependent child, parent, or other caretaker, or  A combination of increased earned income and other factors that create ineligibility. A Medicaid member is a person who has been successfully approved on the system. Transitional Medicaid is not available to applicants.

1. The M family has been receiving Medicaid under FMAP for the past six months. They are canceled effective June 1 for failure to provide information. They reapply for Medicaid July 5. On July 7, Mrs. M reports beginning a job July 5. The worker processes the application July 27. The Ms are eligible for Medicaid under FMAP for July, but they are over income for August. Because they are considered members at the point they are successfully entered on the system, they are eligible for transitional Medicaid effective August 1.