TITLE 477 - MEDICAID ELIGIBILITY CHAPTER 14-000 - DEFINITIONS PERTAINING TO MAGI-BASED PROGRAMS Chapters 477 NAC 14 through 19 apply to the following: Parents/Caretaker Relatives, Children/Children in an IMD/Children and Young Adults Eligible for Non-IV-E Assistance, Pregnant Women, 599 CHIP, Former Wards, and Hospital Presumptive. 599 CHIP: Health care coverage for eligible unborn children of pregnant women who are without pregnancy-related coverage and are otherwise ineligible for Medicaid. Advanced Payments of the Premium Tax Credits (APTC): A payment of the tax credits that are provided on an advance basis to an eligible individual enrolled in a qualified health plan (QHP) through an Exchange. Children’s Health Insurance Program (CHIP): Health care coverage for eligible children eighteen (18) years old and younger who are without other health insurance and who do not otherwise qualify for Medicaid. Family Size Using Modified Adjusted Gross Income (MAGI)-Based Methodology: The number of persons counted as members of an applicant’s/client’s household. When determining the family size of other individuals who have a pregnant woman in their household, the family size is counted as the pregnant woman plus the number of children she is expected to deliver. Household Size Using MAGI-Based Methodology: The group of individuals who will be included to determine family size for a particular applicant and whose income may be counted toward the applicant’s total household income for purposes of determining his/her eligibility for Medicaid or CHIP. Household Income Using MAGI-Based Methodology: The sum of an applicant’s/client’s MAGI and the MAGI of tax dependents in the family, if required to file a tax return. Insurance Affordability Program: A program that is one of the following: 1. Medicaid, including CHIP or a state basic health program; 2. Coverage in a qualified health plan (QHP) through the Exchange; or 3. Advanced Payments of the Premium Tax Credit (APTC) and Cost Sharing Reductions (CSR). Modified Adjusted Gross Income (MAGI): The methodology used to determine financial eligibility. Non-Filer: Individuals who do not expect to file a tax return and do not expect to be claimed as a tax dependent for the taxable year.

Tax Dependent: An individual for whom another individual claims a deduction for a personal exemption for a taxable year. Tax Filer: An individual who intends to file a federal tax return for the coverage year and who is not claimed as a tax dependent by another taxpayer for that tax year.