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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M04 July 2025 Subchapter Subject Page ending with Page M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) M0440.100 14

G. Tax Filer, Her Son and Her Nephew

H. Tax Filer, Spouse, Their Child, His Parent Not Living In the Home Daria lives with her son, Jack age 11, and her nephew Billy age 8. All applied for MA. Daria is a tax filer who claims her son and nephew as dependents. Her MAGI household is the same as her tax household. Jack is a tax dependent and no exceptions exist; his MAGI household is the same as the tax household. Billy is a tax dependent claimed by a tax filer who is not his parent so an exception exists and non-filer rules are used. Billy’s MAGI household consists of Billy only because he has no parents or siblings in the home. The following table shows each person’s MAGI household:

Person # - Household Composition Reason Daria 3 – Daria, Jack and Billy Tax filer and dependents Jack 3 – Daria, Jack and Billy Tax filer and dependents Billy 1 – Billy Non filer rules; Daria is not his parent, Jack is not his sibling Dave lives with his wife Jean and their child, Cathy age 8. Dave files taxes separately from his wife who files her own taxes each year. Dave claims their child Cathy and his mother, Becky, as his tax dependents. Dave, Jean and Cathy applied for MA.

Dave’s MAGI household includes the individuals in his tax household and his wife, Jean because married spouses are always included in each other’s MAGI household. Jean is also a tax filer with no additional dependents. Jean’s MAGI household includes Dave because married spouses are always included in each other’s MAGI household. Cathy is a tax dependent whose parents are not filing jointly so non-filer rules are used; her MAGI household includes herself and her parents. The following table shows each person’s MAGI household:

Person # - Household Composition Reason Dave 4 – Dave, Jean, Cathy and Becky Tax filer, spouse, dependent child and dependent parent Jean 2 – Dave, Jean, Tax filer and spouse Cathy 3 – Cathy, Dave, Jean Non filer rules; child and parents in home M0440.100 HOUSEHOLD INCOME

A. General Rule The income counted under MAGI rules is the income counted for federal tax purposes with few exceptions. All taxable income sources and some non-taxable income sources are counted for the MA eligibility determinations. Whenever possible, income, including income from self-employment, reported on the application will be verified through available electronic data sources. The agency must utilize online systems that are available to the agency without requiring verifications from the individual or family. If no data sources exist to verify the attestation, and the attestation is below the medical assistance income level, documentation of income is required. The agency has ready access to Supplemental Nutrition Assistance Program (SNAP) and TANF records, some wage and payment information and information from SSA through SVES or SOLQ-I. Verification of income from available sources, including the VEC, may be used if it is dated within the previous 6 months. The agency must include in each applicant’s case record facts to support the agency’s decision on the case.