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Louisiana Medicaid Eligibility Manual Eligibility Factors

Issued January 7, 2026 Page 1 of I-1550 Replacing November 13, 2025

Revised/added text indicated by underscore Deleted text indicated by “**” I-1550 MAGI DETERMINATIONS

I-1551 MODIFIED ADJUSTED GROSS INCOME (MAGI)

Effective January 1, 2014, the Modified Adjusted Gross Income (MAGI) methodology is used to determine financial eligibility for:  Medicaid,  Children’s Health Insurance Programs (CHIP),  Cost sharing reductions, and  Advanced premium tax credits (APTC) through the Federally Facilitated Marketplace (FFM).

This change was made in accordance with Section 1004(a)(2) of the Patient Protection and Affordable Care Act of 2010, and codified at Section 36B(d)(2)(B) of the Internal Revenue Code.

MAGI is a methodology, based on federal tax rules, for determining income and household composition. It is not a number on a tax return, but it is based on federal rules for determining adjusted gross income.

MAGI-based rules are used to determine eligibility for the following groups of applicants/beneficiaries:  Adults age 19-64;  Parents and Caretaker Relatives (PCR);  Pregnant Women (PW);  Child-related groups; and  Other adult-related groups:  Breast and Cervical Cancer (BCC);  Refugee Medical Assistance (RMA);  Regular and Spend-Down Medically Needy;  Take Charge Plus (TCP); and  Tuberculosis (TB).

Note: The MAGI methodology is not used to determine financial eligibility for the Medicare Savings Program (MSP) or non- MAGI-related program groups (i.e. the aged, blind, or disabled categories).