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Title 8: Medicaid Page 60 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups MAGI-Related Coverage Groups Revised February 28, 2025 Medicaid/Hawki Composite Families

1. Ms. B applies for Hawki for her son. Family income exceeds 167% of poverty for a two-member eligible group. Hawki eligibility is established for Ms. B’s son effective April 1. In July, Ms. B applies for Medicaid because she is pregnant. The same family income is now below 167% of poverty for a three-member eligible group (Ms. B, her son, and the unborn child). Ms. B chooses to have her son remain on Hawki until the Hawki annual review. Household size continues to be determined using MAGI-related Medicaid policy. 2. Mr. and Mrs. C apply for Hawki for their three children. Family income exceeds 167% of poverty for a five-member eligible group. Hawki eligibility is established for the three children effective June 1. In October, Mr. and Mrs. C apply for Medicaid. While determining eligibility, the worker determines that family income is now less than the FMAP limit for a five-member eligible group. If the Cs choose to have their children remain on Hawki until the Hawki annual review, household size is determined using MAGI-related Medicaid policy. The Cs could also decide to have only one or two of their children begin receiving Medicaid and let the others stay on Hawki. People in a Medical Institution Within the 300% Income Limit Legal reference: 441 IAC 75 (Rules in Process) Medicaid is available to a child under age 21 who meets all the following conditions:  Has received care in a medical institution for 30 consecutive days.  Meets the level of care requirements for the institution, as determined by the Iowa Medicaid Enterprise (IME).  Has gross countable monthly income that does not exceed 300% of the SSI benefit standard for one. Children who are eligible under another coverage group (except Medically Needy) are not eligible under this coverage group. Disregard the resources of all household members in determining eligibility of people under age 21 in this coverage group. See People in Medical Institutions: 300% Income Level and 8-N, Determining Coverage Group for more information on determining eligibility.