Page 19
18
Charlotte lives with her parents and is pregnant with twins. Her parents file a joint return and claim her and her younger brother as dependents. As a tax dependent, Charlotte’s AG is the same as the tax filers that claim her. In addition, because she is pregnant, her AG will include her unborn children.
Charlotte’s AG consists of herself, both of her parents, her brother, and her unborn children.
Her parents are tax filers, so their AG consists of themselves and their 2 children. They cannot include Charlotte’s unborn children in their AG’s.
Example 2: Emily is pregnant with her fourth child. She lives with her husband and their other three children. Emily files taxes jointly with her husband, so Emily’s AG is determined in accordance with the rules for tax filers. Her AG consists of herself, her husband, their three children and the unborn child.
Her husband’s AG consists of himself, Emily, and his three children. He cannot count the unborn child in his AG.
The three children’s AG consists of the parents and siblings. Emily’s unborn child cannot be counted in their AG’s.
3220.20.00 AG DETERMINATION/NEWBORNS
The policy in this section applies to the MA X category. (Refer to Sections 1620.75.00 and 2428.00.00 for category description and eligibility information).
The AG consists only of the newborn child.
There is no financial eligibility determination for this category.
3220.25.00 AG DETERMINATION/FAMILY PLANNING SERVICES
The policy in this section applies to the MA E category. (Refer to Section 1620.80.00 and 2410.05.05).
This category of assistance is subject to MAGI methodology for household size and composition.
3225.00.00 QMB/QDW/SLMB/QI ASSISTANCE GROUPS (MED 4) The members of a Qualified Medicare Beneficiary (QMB), (refer to 1610.30.00 for category description); Qualified Disabled Worker (QDW), (refer to 1610.40.00 for category description); Specified Low-Income Medicare Beneficiary (SLMB) (refer to 1610.35.00 for category description) and Qualified Individuals (QI) (refer to 1610.45.00 for category description) AGs are as follows: