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Title 8: Medicaid Page 91 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Non-MAGI-Related Coverage Groups Revised May 22, 2026 People in Medical Institutions  Transfers between one type of institution to another (for example, from a hospital to a nursing facility). Time spent as a resident of a mental health institute counts toward meeting the 30-day residency requirement, even for people over age 20 but under age 65 who are not eligible for Medicaid in the mental health institute. Examine eligibility under the 300% coverage group for people under the age of 21 in an institution who are not blind or disabled based on SSI criteria and who do not qualify for Medicaid under another coverage group. Use SSI policy to determine the countable income of all children in an institution.  If the child will be in the facility a full calendar month, do not consider parental income for eligibility.  If the child will not be in the facility a full calendar month for the month of entry, deem parental income in the month of entry to a child under 21 for the initial month of eligibility. Follow SSI deeming policies in 8-E, Deeming Non-MAGI-Related Income. To examine eligibility under this coverage group: 1. Check that the client has not transferred assets to become eligible for Medicaid. See 8-D, Transfer of Assets. If so, this disqualifies the person in a facility for nursing facility services. Other services may be covered if the person is eligible for this group. To accomplish this, manually determine eligibility and put the person in a coverage group that does not pay the facility but pays for other medical services. Do not do this for waiver cases. 2. Determine assets to be attributed to the spouse of an institutionalized person. See 8-D, Attribution of Resources. 3. Use SSI policy to calculate the client’s gross income. See 8-E. Do not allow the earned income disregard and the general disregard of income. Compare the gross income to the 300% limit of $2,982. If both spouses enter a medical institution and live in the same room, the income limit is two times $2,982 or $5,964. 4. If the person meets all requirements (including level of care), eligibility begins the first of the month of application or entry to a medical institution, whichever is later. People who have lived in a medical institution as private-pay patients may be eligible under this coverage group in the retroactive period as long as they meet a category of eligibility for the retroactive period as defined in 8-A, Definitions.