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Official source

Manual Title Virginia Medical Assistance Eligibility Chapter M04 Page Revision Date January 2026 Subchapter Subject M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) Page ending with M0450.300 Page 30

A. Example #2 Non Tax Filer Three Generation Household (Using Jan. 18, 2018 figures) Sally Green is age 64, a grandmother who does not expect to file taxes this year. She is neither blind or disabled. She lives with her daughter Jane, age 20 and a full-time student, and her granddaughter Dee (Jane’s daughter), age 2. Sally takes care of Dee while Jane is attending school and working at her part-time job. Jane is pregnant with 1 unborn. They live in Hanover, a Group I locality. Sally doesn’t have Medicare. Income: Sally receives SSA widow’s benefits of $1,000 per month.

Jane earns $300 per month or $3,600 annually and is not required to file taxes.

The MAGI non-filer households are:

Person # - Household Composition Reason Sally 1 – Sally Non-filer grandmother Jane (PG) 3 – Jane, Jane’s unborn child & Dee Non-filer, her unborn child & non-filer’s child < 19 Dee 2 – Dee, Jane Non-filer child < 19 & non- filer child’s parent

Sally’s eligibility determination: Potential covered groups: Plan First MAGI Adult Monthly Income limits: MAGI Adult income limit for HH of 1=$1,346 Plan First 200% FPL income limit for HH of 1 = $2,024 5% FPL for 1 = $51 HH gross monthly income = $1,000 Sally’s SSA benefits Her gross income of $1,000 is less than the MAGI Adult limit of $1,346 for 1. Sally is eligible for full coverage in the MAGI Adult coverage group.

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Page 39

Official source

Manual Title Virginia Medical Assistance Eligibility Chapter M04 Page Revision Date January 2026 Subchapter Subject M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) Page ending with M0450.300 Page 30

A. Example #2 Non Tax Filer Three Generation Household (Using Jan. 18, 2018 figures) Sally Green is age 64, a grandmother who does not expect to file taxes this year. She is neither blind or disabled. She lives with her daughter Jane, age 20 and a full-time student, and her granddaughter Dee (Jane’s daughter), age 2. Sally takes care of Dee while Jane is attending school and working at her part-time job. Jane is pregnant with 1 unborn. They live in Hanover, a Group I locality. Sally doesn’t have Medicare. Income: Sally receives SSA widow’s benefits of $1,000 per month.

Jane earns $300 per month or $3,600 annually and is not required to file taxes.

The MAGI non-filer households are:

Person # - Household Composition Reason Sally 1 – Sally Non-filer grandmother Jane (PG) 3 – Jane, Jane’s unborn child & Dee Non-filer, her unborn child & non-filer’s child < 19 Dee 2 – Dee, Jane Non-filer child < 19 & non- filer child’s parent

Sally’s eligibility determination: Potential covered groups: Plan First MAGI Adult Monthly Income limits: MAGI Adult income limit for HH of 1=$1,346 Plan First 200% FPL income limit for HH of 1 = $2,024 5% FPL for 1 = $51 HH gross monthly income = $1,000 Sally’s SSA benefits Her gross income of $1,000 is less than the MAGI Adult limit of $1,346 for 1. Sally is eligible for full coverage in the MAGI Adult coverage group.