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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M04 October 2018 Subchapter Subject Page ending with Page M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) M0450.200 22 M0450.200 INCOME EXAMPLES – TAX FILER HOUSEHOLDS
A. Example #1 Tax Filer Single Parent, Two Children (Using Jan. 18, 2018 Tom is a single parent living in Henrico County (Group II) with his two children, Jack and Betty, ages 6 and 10, whom he claims as tax dependents. Tom earns $3,000 per month, with projected annual income of $36,000. figures) The MAGI households are:
Person # - Household Composition Reason Tom 3 – Tom, Jack, Betty Tax-filer & 2 dependents Jack 3 – Jack, Tom, Betty Tax dependent, taxpayer & other tax dependent Betty 3 – Betty, Tom, Jack Tax dependent, taxpayer & other tax dependent
Tom (parent) eligibility determination:
Potential covered groups: LIFC (full-coverage MA) MAGI Adults (full-coverage-MA) Plan First (limited coverage) Monthly Income limits: LIFC, Group II for HH of 3 = $589 MAGI Adults for HH of 3=$2,391 Plan First 200% FPL for HH of 3 = $3,464 5% FPL Disregard for HH of 3 = $86 Tom’s gross HH income of $3,000.00 exceeds the LIFC income limit of $589 for a HH of 3, so he is entitled to a 5% FPL disregard. $3,000.00 gross household income - 86.00 5% FPL Disregard for HH of 3 $2,914.00 countable income (after disregard) His countable income of $2,914.00 is compared to the LIFC income limit for HH of 3 which is $589 ; income exceeds the LIFC limit. Tom is not eligible for full-coverage MA.
His countable income of $2,914 is compared to the MAGI Adult income limit for household of 3 which is $2,391. Toms income exceeds the MAGI Adult, therefore making him ineligible for full coverage MA
Tom’s gross HH income of $3,000.00 is then compared to the Plan First 200% FPL income limit for 3 which is $3,464. As his income is under the limit, no disregard is needed; Tom is eligible for Plan First. Tom is also referred to the Health Insurance Marketplace (HIM)