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b) Domestic employees;

c) Service not in the course of the employer's trade or business;

d) Service by certain home workers;

e) Members of the Uniformed Services;

f) In the form of food and/or shelter which is on the employer's business premises for the employer's convenience and, if shelter, its acceptance by the employee is a condition of employment

Source: Social Security Act §1902 (r)(2); 42 CFR § 435.601(b) (Rev 1994).

Part 104 Chapter 11: Introduction to Income – FCC Programs

Rule 11.1: Income Rules

A. The Affordable Care Act (ACA) requires that state Medicaid programs use modified adjusted gross income or MAGI-based methodology for determining the income of an individual and the individual’s household. MAGI methodology and rules are required in determining eligibility for Medicaid or CHIP or an 1115 demonstration that involve FCC covered populations of children, pregnant women and parents and needy caretaker relatives. The ABD population is exempt from MAGI rules.

B. The MAGI methodology is aligned with the process used to determine eligibility for the premium tax credits and cost sharing reductions available to certain individuals purchasing coverage through the federal health insurance marketplace. The requirement that both Medicaid and the marketplace use MAGI-based income methodologies is designed to promote coordination and avoid gaps in coverage, to the extent possible, for individuals that transfer between different types of insurance affordability programs.

C. The use of liberalized income rules under 1902(r)(2) of the Social Security Act is prohibited under MAGI based methodology. This provision is only available to certain ABD covered categories of eligibility.

Source: 42 CFR§ 435.603 (Rev. 2012)

Rule 11.2: MAGI Defined

A. MAGI and household income are defined in section 36B(d)(2)(A) and(B) of the Internal Revenue Code (IRC). The treatment of income is based on IRS tax rules, except for specified exceptions.