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Title 8: Medicaid Page 58 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 Redetermine Medicaid eligibility under another coverage group and issue timely notice when an infant or child loses eligibility because of an age change and when it is not known if the child is an inpatient in a medical institution. Do not consider the age change until the infant or child leaves the medical institution. All other eligibility factors continue to apply.

1. Carey is an infant who currently receives Medicaid under MAC. On June 10, Carey turns one year old. The ELIAS system completes an automatic redetermination and issues a Notice of Action canceling Medicaid benefits effective July 1, since the family’s income exceeds the income limits. The family informs the local office and verifies that Carey was admitted into the hospital May 30 and is expected to remain in the hospital until August 15. Although the household’s income exceeds 167%, it remains less than 300% of the federal poverty level. Therefore, Carey remains Medicaid- eligible under MAC through the end of August, because she meets all MAC eligibility factors for infants, except for age. 2. Sarah, age 18, is currently receiving Medicaid under MAC. In August, an automatic redetermination is completed because of her nineteenth birthday on August 22. The household verifies that Sarah is an inpatient in a medical institution and is expected to remain there until late November. She must continue to meet all MAC eligibility factors for children ages one through 18, except for age. 3. Bobby is an infant in “deemed newborn” status currently receiving Medicaid under MAC. His first birthday is April 15. In March, the worker requests income information to redetermine eligibility. The household states that Bobby is currently in the hospital. Because Bobby is a hospital inpatient, he remains eligible for Medicaid under MAC if the household’s countable income is within 300% of poverty. (He is aged out of the coverage group but still must meet income guidelines in effect when he entered the hospital.)