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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) M0450.100 20 M0450.100 STEPS FOR DETERMINING MAGI-BASED ELIGIBILITY

A. Determine Household Composition 1. Does the individual expect to file taxes? a. If No - Continue to Step 2 b. If Yes - Does the individual expect to be claimed as a tax dependent by anyone else? 1) If No - the household consists of the tax filer, a spouse living with the tax filer, and all persons whom the tax filer expects to claim as a tax dependent. For a tax filer under age 19, parents living in the home are also in the individual’s household. 2) If Yes - Continue to Step 2 2. Does the Individual Expect to be Claimed As a Tax Dependent? a. If No - Continue to Step 3 b. If Yes - Does the individual meet any of the following exceptions? 1) the individual expects to be claimed as a tax dependent of someone other than a spouse or a biological, adopted, or stepparent; or 2) the individual is a child (under age 19) living with both parents, but the parents do not expect to file a joint tax return; or 3) the individual is a child who expects to be claimed by a non-custodial parent; or 4) the child is an adoption assistance child with special needs for medical or rehabilitative care. 5) the child has been residing in a PRTF for more than 30 days. If No to 1) through 4) above - the household is the household of the tax filer claiming her/him as a tax dependent. If Yes to any of 1) through 4) above - Continue to Step 3. 3. Individual Is Neither Tax Filer Nor Tax Dependent Or Meets An Exception In 2. b Above For individuals, other than adoption assistance children with special needs for medical or rehabilitative care, who neither expect to file a tax return nor expect to be claimed as a tax dependent, as well as tax dependents who meet one of the exceptions in 2.b above, the household consists of the individual and, if living with the individual: • the individual’s spouse; • the individual’s natural, adopted and step children under the age 19; and • In the case of individuals under age 19, the individual’s natural, adopted and stepparents and natural, adoptive and stepsiblings under age 19. The household of an adoption assistance child with special needs for medical or rehabilitative care consists only of the child.