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Title 8: Medicaid Page 31 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

2. Same as Example 1, except the worker processes the application August 2. The Ms have Medicaid eligibility under FMAP for July, but they are over income for August. Because they were members in July, they are eligible for transitional Medicaid. 3. Same as Example 1, except the family is over income for July and ongoing. There is no transitional Medicaid eligibility, because they are not members and they were canceled for failure to provide information. Individuals of the transitional Medicaid group may consist of:  The people living in the household whose needs and income were included in determining the FMAP eligibility when the FMAP benefits were terminated.  Ineligible people who were included in the eligible group and whose income was counted in the FMAP eligibility determination.  Children, parents, or other caretakers who reside or begin to reside in the household during the transitional period.  Children who lose deemed newborn status. The earned income must be the earnings of the dependent child, parent, or other caretaker. The parent or other caretaker must either:  Be in the eligible group, or  Have returned to the home and be a person whose income and needs must be considered in the eligibility determination.

1. Ms. T reports the return of the father of the children. Ms. T’s income and the returning parent’s income create ineligibility for FMAP. Therefore, the family (Ms. T, the returning parent, and children) is eligible for transitional Medicaid. 2. Mrs. O reports the return of her husband, the father of her children. Mrs. O is not employed. Mr. O’s income makes the family ineligible for FMAP. Therefore, the family (Mrs. O, Mr. O, and children) is eligible for transitional Medicaid. A member of the FMAP household must have received FMAP in Iowa at least three of the previous six months in order to be eligible for transitional Medicaid.