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Manual Title Virginia Medical Assistance Eligibility Chapter M04 Page Revision Date October 2018 Subchapter Subject M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) Page ending with M0450.200 Page 24

Tax household = Mary, Samantha, and Joy. MAGI Households:

Person # - Household Composition Reason Mary 3 – Mary, Samantha, Joy Tax-filer & 2 tax dependents Samantha 3 – Samantha, Mary, Joy Tax dependent, tax filer, & other tax dependent Joy 2 – Joy, Samantha Non-filer child & child’s parent with whom child lives

Mary’s eligibility determination: Potential covered groups: Plan First MAGI Adult Monthly Income Limits: Plan First income limit for HH of 3 = $3,464 MAGI Adult income limit for HH of 3=$2,391 5% FPL Disregard for HH of 3 = $86 HH gross monthly income: $4,500 Mary’s earnings (Samantha’s earnings are excluded because she is a child for tax purposes and is not required to file taxes). 4,500.00 gross household income - 86.00 5% FPL Disregard for HH of 3 $4,414.00 countable income (after 5% FPL disregard)

Her gross income of $4,500 is compared to the MAGI Adult income limit for household of 3 which is $2,391. Mary’s income exceeds the MAGI Adult limit. After subtracting the 5% FPL disregard, the countable income of $4,414.00 is then compared to the MAGI Adult income limit of $2,391 and her countable income exceeds the MAGI Adult limit, Mary is not eligible for full coverage MA.

The gross HH income of $4,500.00 is compared to the Plan First 200% FPL income limit for 3, $3,490. As the gross HH income exceeds the limit, she is entitled to the 5% FPL disregard. The countable income of $4,414.00 is then compared to the Plan First income limit of $3,464; but as her countable income exceeds the Plan First limit, Mary is not eligible for Plan First. Mary is referred to the HIM