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West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 169 Chapter 4 Income

Example 1: Daisy is enrolled in Medicaid with MAGI-based household income of $1.200 per month. She is single and has no dependents. On January 4, 2020, Daisy wins $192,000 playing roulette. Using the chart in Chapter 4 Appendix H, we see that Daisy winnings of $192,000 are counted in her MAGI-based income for 13 months, including the month in which she receives the winnings. They are counted in January 2020 through January 2021. An equal amount of $14,769 is counted in each month ($192,000/13 months = $14,769 per month). Daisy’s MAGI-based monthly income for January 2020 through January 2021 is $15,969 ($14,769 gambling winnings plus $1,200 other MAGI-based income) assuming no changes to her other MAGI-based income. Because Daisy’s income exceeds the state’s MAGI- based income standard, the agency would provide Daisy with a notice alerting her that she is no longer eligible for Medicaid and her coverage will be terminated following the advance notice period. The notice will also tell Daisy that beginning January 1, 2020, her gambling winnings will no longer be counted in her MAGI-based income. Example 2: Rose is a single parent who lives with her son, Rowan, who is age 7. Rose and Rowan have monthly MAGI-based income of $2,000 from Rose’s job. On April 14, 2020, Rose submits a Medicaid application for Rowan. The following week Rose wins the state lottery and receives a lump sum payment of $755,000. For the month of April, Rowan’s MAGI-based household income will be calculated as $755,000 in lottery and gambling winnings, plus $2,000 in the other MAGI-based income, for a total monthly income of $757,000 for a family of two. For the month of May, Rowan’s income will be $2,000. Rose’s lottery winnings would court toward Medicaid, using the chart, her winnings if $755,000 would be counted in her MAGI-based income for 69 months (or, 5 years and 9 months), beginning in the month in which she receives the winnings. Rose’s winnings would be counted in her MAGI-based income in April 2020 through December 2025. An equal amount of $10,942 would be counted in each month ($755,000/69 months = $10,942 per month).

If a Medicaid or WVCHIP applicant or beneficiary incurred winnings from lottery or gambling multiple times, in amounts over $80,000, the lottery and gambling winnings are counted concurrently (each instance beginning and ending per the formula) and applied separately to each instance of winning.