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West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 161 Chapter 4 Income

3. Determining Eligibility: Convert the gross monthly income for each applicant’s MAGI household to a percentage of the FPL. To convert MAGI household income to a percentage of the FPL and determine eligibility, follow these steps: Birch and Aspen: Birch and Aspen’s MAGI household income would be converted using the following steps: • Determine gross monthly income: $1,400. • Determine MAGI household size: Three. • Determine 100% FPL for the household size of three: $1,702. • Divide gross monthly income by 100% of the FPL for the household size: $1,400/$1,702 = .82256. • Move decimal point two places to the right: .82256 = 82.26% FPL. • Compare 82.26% FPL to the income threshold for each coverage group. • The 5% FPL disregard is not required because the applicants are eligible for a MAGI Medicaid coverage group. Birch and Aspen’s MAGI household income is below the Medicaid income limit; therefore, both will be eligible for Medicaid. Lily: Lily’s MAGI household income would be converted using the following steps: • Determine gross monthly income: $1,300. • Determine MAGI household size: one. • Determine 100% FPL for the household size of one: $1,005. • Divide gross monthly income by 100% of the FPL for the household size: $1,300/$1,005 = 1.2935. • Move decimal point two places to the right: 1.2935 = 129.35% FPL. • The 5% FPL disregard is not required because the applicant is eligible for a MAGI coverage group. Lily’s MAGI household income exceeds the income standard for the Adult Group. Her electronic account will be referred to the Marketplace to be evaluated for financial assistance with purchasing health insurance using APTC. Ginger: Ginger’s MAGI household income would be converted using the following steps: