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West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 157 Chapter 4 Income

Pregnant Woman Example 1: A pregnant woman has MAGI household income at 135% of the FPL. The 5% FPL disregard will not be applied because the highest income limit of the MAGI Medicaid coverage group for which she may be eligible is 185% of the FPL for the Pregnant Women coverage group. Pregnant Woman Example 2: A pregnant woman has MAGI household income at 190% of the FPL. The 5% FPL disregard would be applied to bring her income to below 185% of the FPL. Adult Group Example 1: A client has MAGI household income at 137% of the FPL. The 5% FPL disregard would be applied to bring his income below 133% of the FPL for the Adult Group. 4.7.4 DETERMINING ELIGIBILITY The applicant’s household income must be at or below the applicable MAGI standard for the MAGI coverage groups. Step 1: Determine the MAGI-based gross monthly income for each MAGI household income group (IG). Step 2: Convert the MAGI household’s gross monthly income to a percentage of the FPL by dividing the current monthly income by 100% of the FPL for the household size. Convert the result to a percentage. If the result from Step 2 is equal to or less than the appropriate income limit, no disregard is necessary, and no further steps are required. Step 3: If the result from Step 2 is greater than the appropriate limit, apply the 5% FPL disregard by subtracting five percentage points from the converted monthly gross income to determine the household income. Step 4: After the 5% FPL income disregard has been applied, the remaining percent of FPL is the final figure that will be compared against the applicable modified adjusted gross income standard for the MAGI coverage groups.