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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 142 Chapter 1 Application/Redetermination Process

1.8 MAGI ADULT GROUP The Affordable Care Act (ACA) established a categorically mandatory coverage group known as “the Adult Group.” Eligibility for this group is determined using MAGI methodologies. 1.8.1 WHO CAN BE INCLUDED ON THE SAME APPLICATION? • Spouses • Individuals who are a tax dependent of, or on the same income tax return with, the applicant. • Individuals who are under age 19 and residing with the application filer may be included on an application submitted by an adult application filer, even if the child and application filer are not in a familial or tax relationship. Adult individuals who do not fall into one of these categories will be notified that they must submit a separate application. 1.8.2 WHO MUST SIGN? The application must be signed by an adult in the household or their authorized representative. 1.8.3 AGENCY TIME LIMITS EXCEPTION: A non-custodial parent cannot apply for Medicaid or WVCHIP for their child even when claiming their child as a tax dependent. In this situation, based on MAGI rules, the child’s MAGI household includes - himself, his parents (biological, adopted or step parents), and siblings (biological, adopted or step) under 19 with whom he resides. Information necessary to determine the child’s eligibility cannot be determined based on the non-custodial parent’s application; therefore, the case should fail for the child with the reason that the non-custodial parent cannot apply for the child.

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Page 175

Official source

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 142 Chapter 1 Application/Redetermination Process

1.8 MAGI ADULT GROUP The Affordable Care Act (ACA) established a categorically mandatory coverage group known as “the Adult Group.” Eligibility for this group is determined using MAGI methodologies. 1.8.1 WHO CAN BE INCLUDED ON THE SAME APPLICATION? • Spouses • Individuals who are a tax dependent of, or on the same income tax return with, the applicant. • Individuals who are under age 19 and residing with the application filer may be included on an application submitted by an adult application filer, even if the child and application filer are not in a familial or tax relationship. Adult individuals who do not fall into one of these categories will be notified that they must submit a separate application. 1.8.2 WHO MUST SIGN? The application must be signed by an adult in the household or their authorized representative. 1.8.3 AGENCY TIME LIMITS EXCEPTION: A non-custodial parent cannot apply for Medicaid or WVCHIP for their child even when claiming their child as a tax dependent. In this situation, based on MAGI rules, the child’s MAGI household includes - himself, his parents (biological, adopted or step parents), and siblings (biological, adopted or step) under 19 with whom he resides. Information necessary to determine the child’s eligibility cannot be determined based on the non-custodial parent’s application; therefore, the case should fail for the child with the reason that the non-custodial parent cannot apply for the child.