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Official source

Title 8: Medicaid Page 48 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

1. Mr. and Mrs. P apply for Medicaid for their daughter, Jennifer, whose birthday is May 11. Jennifer is eligible under the MAC coverage group. When Jennifer turns 19, her MAC eligibility will end effective June 1. 2. The same as Example 1, except that Jennifer’s birthday is April 1. When Jennifer turns 19, her MAC eligibility will end effective April 1. See Continuous Eligibility for Children for more information on handling an increase in household income that affects a child’s eligibility. MAC Income Limits Legal reference: 441 IAC 75 (Rules in Process) Policy: When determining initial and ongoing eligibility for MAC, the income limits are:  215% of the federal poverty level for pregnant women.  300% of the federal poverty level for infants under age 1.  167% of the federal poverty level for children ages 1 through 18.

Monthly Income Limit Household Size Children 1 through 18: 167% of Poverty Infants under age 1: 300% of Poverty Pregnant Women: 215% of Poverty 1 $2,178 $3,913 $2,804 2 $2,944 $5,288 $3,790 3 $3,709 $6,663 $4,775 4 $4,475 $8,038 $5,761 5 $5,240 $9,413 $6,746 6 $6,006 $10,788 $7,732 7 $6,771 $12,163 $8,717 8 $7,536 $13,538 $9,702 Procedure: Complete an automatic redetermination whenever the net countable income exceeds the established limits under the MAC coverage group.

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Page 52

Official source

Title 8: Medicaid Page 48 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

1. Mr. and Mrs. P apply for Medicaid for their daughter, Jennifer, whose birthday is May 11. Jennifer is eligible under the MAC coverage group. When Jennifer turns 19, her MAC eligibility will end effective June 1. 2. The same as Example 1, except that Jennifer’s birthday is April 1. When Jennifer turns 19, her MAC eligibility will end effective April 1. See Continuous Eligibility for Children for more information on handling an increase in household income that affects a child’s eligibility. MAC Income Limits Legal reference: 441 IAC 75 (Rules in Process) Policy: When determining initial and ongoing eligibility for MAC, the income limits are:  215% of the federal poverty level for pregnant women.  300% of the federal poverty level for infants under age 1.  167% of the federal poverty level for children ages 1 through 18.

Monthly Income Limit Household Size Children 1 through 18: 167% of Poverty Infants under age 1: 300% of Poverty Pregnant Women: 215% of Poverty 1 $2,178 $3,913 $2,804 2 $2,944 $5,288 $3,790 3 $3,709 $6,663 $4,775 4 $4,475 $8,038 $5,761 5 $5,240 $9,413 $6,746 6 $6,006 $10,788 $7,732 7 $6,771 $12,163 $8,717 8 $7,536 $13,538 $9,702 Procedure: Complete an automatic redetermination whenever the net countable income exceeds the established limits under the MAC coverage group.