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Title 8: Medicaid Page 41 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 Also add the following people to the eligible transitional 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 to the home from foster care, if they would have been included if they were 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 or other MAGI-related coverage groups.

1. Ms. M receives FMAP for herself and Child A. Child B receives SSI and is not included in the FMAP eligible group. Ms. M becomes employed and her earnings create FMAP ineligibility. Ms. M and Child A are placed on transitional Medicaid. Due to Ms. M’s increased income, Child B also loses SSI eligibility.

Since Child B would have been included in the FMAP eligible group except for the receipt of SSI, Child B is added to the transitional Medicaid group effective the first day of the month following the last month in which Child B received SSI. 2. Ms. A and her two children are receiving FMAP. Ms. A’s earned income creates FMAP ineligibility, and Ms. A and her children begin receiving transitional Medicaid March 1. On May 7, Ms. A reports that one of her children has left the home and is residing with the father. The child is removed from the transitional Medicaid eligible group effective June 1.

On July 28, Ms. A reports the child returns home. Because the child would be part of the FMAP group if applying in the current month, the child is added to the transitional Medicaid group effective July 1. 3. Mr. and Mrs. B and their three children begin receiving transitional Medicaid August 1. On January 20, Mrs. B gives birth. The baby may be added to the transitional Medicaid group effective January 1 or be eligible for Medicaid as the deemed newborn child of a Medicaid-eligible mother effective January 1.