Page 630
West Virginia Income Maintenance Manual Chapter 4
West Virginia Income Maintenance Manual Page 158 Chapter 4 Income
4.7.4.A MAGI Screening Applicants with income below the MAGI standard and determined eligible for coverage in a MAGI coverage group, i.e., the Adult group, Parents/Caretaker Relatives, Pregnant Women, Children Under Age 19 group or WVCHIP, should be promptly enrolled into the MAGI coverage group. The client may also pursue eligibility for non-MAGI Medicaid coverage groups while enrolled in the MAGI group. See Section 23.8.2 4.7.4.B Eligibility Determination Examples Example 1: Cedar and Holly are married and live together with their son Ash, age 6. Cedar and Holly file a joint tax return, with Ash claimed as a tax dependent. The family applies for health coverage for all three family members. Cedar works and earns $1,500 per month and Holly receives SSA benefits in the amount of $450 per month. Ash has no income. 1. Determine the MAGI Household Size for Each Applicant: • Cedar is a tax filer. Using STEP 1 in Section 4.7.2.A, his MAGI household consists of his spouse Holly, and his tax dependent, Ash, resulting in a MAGI household size of three – Cedar + Holly + Ash. • Holly is also a tax filer; therefore, both her spouse, Cedar, and her tax dependent, Ash, count in her MAGI household, resulting in a MAGI household size of three – Cedar + Holly + Ash. • Ash is a tax dependent and does not meet any of the exceptions in STEP 2 in Section 4.7.2.B; therefore, his MAGI household is the same as Cedar, the tax filer claiming him as a dependent, resulting in a MAGI household size of three – Cedar + Holly + Ash.
NOTE: If the household income of an applicant using MAGI methodologies results in financial ineligibility for Medicaid, and the tax household income of the applicant used to determine eligibility for advance premium tax credits (APTC) through the Marketplace is below 100% FPL resulting in ineligibility for APTC, eligibility for Medicaid will be determined using the tax household methodologies.