When deciding on an individual’s eligibility in a MAGI MA-related category, the CAO must count the monthly earned and unearned income of every individual included in the individual’s tax household.
MA financial eligibility is based on current monthly household income in most scenarios. For MAGI MA, some determinations must be reviewed for eligibility based on an annualized calculation. (See Section 312.53, Annualized Income)
Counted and excluded income for MAGI is based on what is included in Adjusted Gross Income (AGI) when filing a tax return with the Internal Revenue Service (IRS). The following income types are not typically included in AGI, but are considered countable for MA purposes:
Retirement, Survivors, and Disability Insurance (RSDI)
NOTE: To determine if RSDI is counted for a child or tax dependent see (Section 312.54, Income of Children and Tax Dependents).
Tax-exempt interest
Foreign earned income (US citizens living abroad)
Certain excluded types and sources of income for MAGI-related MA are listed in this chapter. They are not counted in the MA financial eligibility decision.
The individual must apply for or get any potential source of income available to him or her. The individual must cooperate in obtaining the income, unless they can show good cause for not doing so. If the individual is cooperating, eligibility may not be delayed for the individual or for any child who is applying or receiving MA.
Potential benefits include, but are not limited to, the following:
Retirement benefits.
NOTE: Early retirement Social Security benefits are considered a potential benefit when the individual reaches age 62.
Unemployment compensation.
State or county retirement or disability benefits.
Pensions and annuities.
The CAO must count payments for services as earned income. Earned income includes, but is not limited to the following:
Wages (including tip wages).
Salaries.
Commissions.
Bonuses.
Severance pay.
Self-employment.
NOTE: Because MAGI uses IRS guidelines for determining household income, all expenses reported on the household's 1040 Schedule C (Profit or Loss from Business) are allowable deductions for MAGI. This includes offsetting self-employment losses against other income reported on the IRS form 1040 (see Section 312.63, Offsetting Self-Employment Losses).
Lump Sum-earnings (only in the month it is received).
The CAO must get proof of all earned income and include the proof and the amount in the case record in accordance with
Section 312.71, Verification Requirements.
The CAO must look at the total amount of unearned income in the household when determining MAGI-related MA eligibility.
Unearned income includes, but is not limited to, the following:
Retirement benefits, private pensions and annuities.
Unemployment Compensation.
Retirement, Survivors, and Disability Insurance (RSDI) benefits.
Railroad Retirement
.
NOTE: RSDI income of a child or tax dependent may or may not count for MAGI-related MA. (See Section 312.54, Income of Children and Tax Dependents).
Sick benefits.
Union benefits.
Dividends, royalties and interest posted or received in the calendar month, including tax exempt interest.
Alimony payments.
Child’s unearned income that includes interest and dividends.
Rental income when the property is managed by a third party.
NOTE: If rental property is not managed by third party consider the income self-employment.
Prizes and awards.
NOTE: A prize is a cash payment won in a contest, lottery, or game relating to luck. An individual usually gets an award because of a decision by a court, board of arbitration, or similar legal body.
An individual may receive a prize as a lump sum or in regular payments.
PMA18339312 - Treatment of Cash Support for MAGI-related Medical Assistance February 3, 2017
Lump Sum- unearned (only in the month it is received).
Cash support can only be counted if the person providing the cash support is claiming the individual as a tax dependent, and the tax dependent is not their spouse or their child (biological, adopted or step). If a non-responsible relative is not claiming the individual as a tax dependent, the cash support would not count in the individual’s eligibility determination.
Cash support does not count:
Example 1: An uncle gives $200 every month to his 25 year old nephew. The uncle does not claim the nephew as a tax dependent. The uncle does not expect his nephew to repay this money. The $200 is not counted in the nephew's monthly unearned income.
Example 2: A mother gives $200 every month to her 19 year old son, who she claims as a tax dependent. The mother does not expect her son to repay this money. The $200 is not counted in the son’s unearned income.
Example 3: A mother gives $200 every month to her 19 year old son, who she does not claim as a tax dependent. The mother does not expect her son to repay this money. The $200 is not counted in the son’s unearned income.
Cash support does count:
Example 1: A daughter gives $200 every month to her elderly mother, who she claims as a tax dependent. The daughter does not expect her mother to repay this money. Count the full amount after the first $50. The mother's countable cash support is $150 per month.
Example 2: A grandmother gives $200 every month to her 19 year old grandson, who she claims as a tax dependent. The grandmother does not expect her grandson to repay this money. Count the full amount after the first $50. (See Section 312.52). The grandson's countable cash support is $150 per month.
NOTE: Cash support is money received on a frequent and regular basis with no expectation of repayment.
NOTE: Child support is not considered cash support.
The CAO must verify all unearned income and include the proof and the amount in the case record in accordance with
Section 312.71, Verification Requirements
If a MAGI budget group's monthly income (earned and/or unearned) exceeds the monthly income limit and the income is expected to decrease or terminate, an annualized income calculation must be performed. The expected decrease or termination must be verified in accordance with Section 312.71 Verification Requirements and Section 312.72 Reasonable Compatibility.
To determine annual household income, total the household's countable earned and unearned income from January 1 through December 31 of the year in which the eligibility is being determined and compare to the annual income limit.
Example: Mary (37) is a single adult who applies for health care. She works part-time as a school bus driver. Her current monthly income of $1,390 exceeds the 133% monthly income limit (even with the 5% income disregard applied) for health care coverage (one person 2017 household limit is $1,337 per month and the 5% disregard is $50.25). However, Mary indicates that she does not work at all for the months of June, July and August each year and has provided verification from her employer. Her annual income beginning January 1 and ending December 31 would be $12,510 ($1,390 x 9 months). The 133% annual income limit for a one person household for 2017 is $16,040. When her income is annualized, it is under the 133% annual limit and Mary is eligible for health care coverage.
Example: John (46) is applying for healthcare for himself and his son, Doug (14). He submits his application to the CAO on June 29. John was working full-time up until this point. He had an accident at home and indicates that he will be out of work until October 1. John’s monthly wages were $2,000 per month and he received his most recent pay on June 26. He has verification from his employer that he will not receive another pay until he returns to work. John’s income in the application month exceeds the 133% monthly income limit (even with the 5% income disregard applied) for health care coverage (two person 2017 household limit is $1,800 per month and the 5% disregard is $67.70). His annual income beginning January 1 and ending December 31 would be $18,000 ($2,000 x 9 months). The 133% annual income limit for a two person household for 2015 is $21,600. Both John and Doug would qualify for health care.
Example: Betty (59) is applying for healthcare for herself. She submits an MA application on June 14. She is receiving unemployment compensation of $1,600 per month. Her current monthly income exceeds the 133% monthly income limit (even with the 5% income disregard applied) for health care coverage (one person 2017 household limit is $1,337 per month and the 5% disregard is $50.25). Betty provides verification that her unemployment compensation will run out at the end of June. Her annual income beginning January 1 through December 31 would be $9,600 ($1,600 x 6 months). The 133% annual income limit for a one person household for 2017 is $16,040. When her income is annualized, it is under the 133% annual limit and Betty is eligible for health care coverage.
To determine if the MAGI-related income of a child or tax dependent is countable review these two factors:
With whom the child or tax dependent resides;
Whether the child or tax dependent would be required to file a tax return.
Child or Tax Dependent Living with Biological, Adoptive or Step-Parent
If the child or tax dependent is required to file a tax return for the taxable year in which eligibility for MA is being determined, count all of the MAGI-related income
Example: Mary applies for MA for herself and her son, Marty (16). Mary will file taxes and will claim Marty as a dependent. Marty works part-time and his annual earnings exceed the tax filing threshold for a child or tax dependent. When determining eligibility for both Mary and Marty, Marty’s income is counted.
If the child or tax dependent is not required to file to a tax return for the taxable year in which eligibility for MA is being determined, exclude all of the MAGI-related income
Example: Steve applies for MA for himself and his daughter, Amy (17). Neither Steve nor Amy will file taxes, and Amy will not be claimed as a dependent. Amy works part-time and has earnings under the tax filing threshold for a child or tax dependent. When determining eligibility for Steve and Amy, Amy’s income is not counted.
NOTE: The Social Security benefit and Railroad Retirement Tier 1 benefit do not count toward the unearned threshold. See Appendix F for Filing requirements for Tax Dependents.
When determining the child or tax dependent’s eligibility, count all of the child or tax dependent’s MAGI-related income (regardless of whether the child or tax dependent would be required to file a tax return).
Example: Pauline has custody of her granddaughter, Olivia (8) and is applying for MA for both herself and Olivia. Pauline will claim Olivia as a tax dependent. Olivia receives $775 per month in RSDI (Survivor’s). When determining Olivia’s eligibility, all of Olivia’s income will count in her determination.
When determining eligibility for the Non-Parent tax filer.
If the child or tax dependent is NOT required to file a tax return, exclude the child or tax dependent's MAGI-related income, if the Non-Parent plans to claim the child or tax dependent.
If the child or tax dependent is required to file a tax return, count the child or tax dependent's MAGI- related income, if the Non-Parent plans to claim the child or tax dependent.
Example: Pauline has custody of her granddaughter, Olivia (8) and is applying for MA for both herself and Olivia. Pauline will claim Olivia as a tax dependent. Olivia receives $775 per month in RSDI (Survivor’s). When determining Pauline’s eligibility, none of Olivia’s income will count in Pauline’s determination.
NOTE: In some situations, an adult can be claimed as a tax dependent. See Appendix G for Tax Dependent Criteria.
The CAO must not count income from certain sources when deciding whether an individual qualifies for MAGI-related MA.
The CAO must verify and record the reason for excluding the income. It may be necessary to verify the amount of excluded income.
The CAO must not count the following excluded income for MAGI-related MA:
Child Support.
Benefits paid under any law, regulation, or administrative practice administered by the Department of Veterans Affairs, including;
Veteran’s disability benefits.
Education, training and subsistence allowances paid through G.I. Bill.
Worker’s Compensation.
Public Assistance Benefit Payments including but not limited to:
SSI
Temporary Assistance for Needy Families (TANF)
Foster care and adoption subsidy payments.
A lump sum (only counted as income in the month received).
Scholarships, awards or fellowship grants used for education purposes and not for living expenses.
Inheritances
Loans (.eg. students loans, bank loans, personal loans)
Gifts
NOTE: To be considered a gift, a monetary gift must be infrequent and nonrecurring
.
Difficulty of Care payments
A difficulty of care payment is money paid to a non-relative or relative who is under contract with a public or private agency to give care to a person with a mental disability in his or her home. These payments come under other program titles, including the following:
Child or Adult Foster Care
Supplemental Payment to a Domiciliary Care Provider.
Parent of an intellectually disabled child.
Adult and Family Living Services.
NOTE: A Family Living Services payment may come as one payment or as two payments (one for services and one for room and board).
Payments made for care of an individual based on the individual's (HCBS) waiver plan, if:
The payment is received for the are of an individual based on an individual's HCBS waiver care plan,
The care recipient and the are provider live in the same home, and
The care provider provides care for no more than 10 qualified individuals under the age of 19, or no more than 5 qualified individuals age 19 and above.
NOTE: Care providers do not have to be related to the are recipient in order for the income exclusion to apply.
American Indian or Alaska Native income:
Distributions from any property held in trust, subject to Federal restrictions, located within the most recent boundaries of a prior Federal reservation, or otherwise under the supervision of the Secretary of the Interior.
Distributions and payments from rents, leases, rights of way, royalties, usage rights, or natural resource extraction and harvest from;
Rights of ownership or possession of any land located within the most recent boundaries of a prior Federal reservation, or otherwise under the supervision of the Secretary of the Interior.
Federally protected rights regarding off-reservation hunting, fishing, gathering, or usage of natural resources.
Distributions resulting from real property ownership interests related to natural resources and improvements;
Located on or near a reservation or within the most recent boundaries of a prior Federal reservation, or
Resulting from the exercise of federally-protected rights relating to such real property ownership interests
Payments resulting from ownership interests in or usage rights to items that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable Tribal Law or custom.
Student financial assistance provided under the Bureau of Indian Affairs education programs.
Updated March 20, 2018, Replacing July 20, 2017