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Title 8: Medicaid Page 33 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Case Maintenance Additional MAGI-Related Case Maintenance Revised November 4, 2022 Budgeting For Ongoing Eligibility For MAGI-Related…

The worker completes an automatic redetermination to MN for the parents in May, effective June 1. An April/May MN certification period is set up for Mr. K and a June/July MN certification period is set up for Mr. And Mrs. K 8. Addition of Household Member Reported Timely; Cancellation and Automatic Redetermination; Information Received after 10th of Month:

Mr. Q and his children receive Medicaid under FMAP. On April 20, Mrs. Q joins the household and the change is timely reported to the Department. Mrs. Q requests Medicaid and has unearned income. The worker requests necessary information and it is timely provided May 11.

The unearned income makes the family over income for MAGI-related Medicaid. If time permits, the worker completes an automatic redetermination to MN for the parents in May, effective June 1. However, a redetermination must be completed no later than timely notice in June effective July 1. No claim is established in either situation.

The children remain continuously eligible under MAGI-related Medicaid until the annual review. If they are over income for MAGI-related Medicaid at the annual review, they are considered for Hawki.

Alternative Scenario: If the information is not provided by the due date, a Notice of Cancellation is sent canceling Medicaid effective June 1.

If the information is received after timely notice in May, June benefits are reopened and a redetermination would be completed effective July 1. No claim is established. 9.Addition of Household Member Not Reported Timely; Cancellation and Automatic Redetermination; Information Received after 10th of Month:

Mr. S and his children receive Medicaid under FMAP. On April 20, Mrs. S joins the household and the change is reported to the Department untimely on June 30. Mrs. S requests Medicaid and has unearned income. The worker requests necessary information and it is timely provided July 19.

The unearned income makes the family over income for MAGI-related Medicaid. An automatic redetermination must be completed no later than August effective September 1 for Mr. and Mrs. S. If appropriate, a claim is established beginning in May for Mr. S.

If eligibility is only under Medically Needy with a spenddown, the certification periods are May/June and July/August.

The children remain continuously eligible under MAGI-related Medicaid until the annual review. If they are over income for MAGI-related Medicaid at the annual review, they are considered for Hawki.

NOTE: If the annual review is due in April, May or June, continuous eligibility may not apply and an overpayment may have occurred on the children. The effective date of a change that is either reported untimely or not reported at all, is the month following the month in which the change occurred, regardless of when in the month the change occurred and regardless of the effect the change has on eligibility.