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Title 8: Medicaid Page 47 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups MAGI-Related Coverage Groups Revised February 28, 2025 Mothers and Children (MAC) Program

Ms. T, age 24, is pregnant and she lives alone. She verifies that her monthly income is less than 215% of the federal poverty level for two people (herself and the unborn child). Therefore, Ms. T is eligible for MAC coverage. As long as Ms. T continues to meet all other eligibility factors throughout her pregnancy, she continues to be eligible under this coverage group, without regard to changes in household income. If Ms. T is eligible on the last day of her pregnancy, she continues to be eligible through the 12 months following the end of the pregnancy, regardless of her income. Infants under one year of age are eligible under MAC if household income does not exceed 300% of the federal poverty level. See MAC Income Limits.

Mr. and Mrs. D apply for Medicaid under the MAC coverage group for their son, Tim, age 4 months. If the household’s countable monthly income does not exceed 300% of the federal poverty level for a three- member household, Tim is eligible under the MAC coverage group as an infant. If the countable monthly income exceeds 302% of the federal poverty level, examine eligibility under Medically Needy. At the child’s first birthday, determine if the child continues to be eligible for Medicaid. If the child’s first birthday falls on the first day of the month, eligibility as an infant ends on the last day of the previous month. If the child’s first birthday falls on any other day of the month, eligibility ends on the last day of the birth month. Children ages 1 through 18 are eligible under MAC if countable household income does not exceed 167% of the federal poverty level. See MAC Income Limits. If the child’s nineteenth birthday falls on the first day of the month, eligibility ends on the last day of the previous month. If the child’s nineteenth birthday falls on any day other than the first of the month, eligibility ends on the last day of the birth month.