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Title 8: Medicaid Page 22 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance Additional MAGI-Related Case Maintenance Revised November 4, 2022 Adding a New Member to an Existing MAGI-Related Case Adding a New Member to an Existing MAGI-Related Case Legal reference: 441 IAC 76.12(249A) A new application is not required to add a person to an existing MAGI-related eligible group. This includes: ▪ New household members. ▪ Other caretakers. ▪ Newborn children of Medicaid-eligible mothers. ▪ Ineligible household members

1. Ms. C’s two children are receiving MAC. Ms. C is having some medical problems and has asked that she be added to the Medicaid case. Because there is no decrease in income, a paper application is required to determine eligibility under Medically Needy. 2. Same as Example 1 above, except that Ms. C’s income has decreased. She calls her worker to request Medicaid. Due to the decrease in income, Ms. C is determined eligible for MAGI-related Medicaid along with her children. No paper application is necessary, because Ms. C is being added to an existing MAGI-related household. The application date is the date she requested Medicaid. Because a paper application is not needed to add a person to an existing case, it is especially important to document contacts with the client. Detailed case record documentation is crucial to provide pertinent information that would substantiate your actions in the event of a Quality Control (QC) review or an appeal. There is a difference between an inquiry and a report as far as what you do with the information: ▪ An inquiry occurs when the client contacts you to find out about the impact on the client’s case if another person should join the household, but the client is not sure if or when the person may actually join. In this situation, give the client the necessary information, and remind the client to contact you within ten days of when the change occurs or if possible, a week before the change is expected to occur. Document the client contact and your response in the case record. Do not issue a Notice of Decision (NOD). ▪ A report occurs when the client (or the client’s authorized representative) contacts you with an approximate or specific date that the person is expected to join the household. (See 8-F, Newborn Children of Medicaid-Eligible Mothers for information on adding newborns.) NOTE: A parent returning to the home may not be added to the eligible group if the parent was previously sanctioned and the sanction has not been cured. See Other Changes in the Household for more information.