2663 Non-Modified Adjusted Gross Income (MAGI) Budgeting

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Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Non-Modified Adjusted Gross Income (MAGI) Budgeting

Effective Date:

June 2020

Chapter:

2600

Policy Number:

2663

Previous Policy Number(s):

MT 47

Updated or Reviewed in MT:

MT-60

Requirements

Non-Modified Adjusted Gross Income (MAGI) budgeting procedures are used to budget all Non-MAGI Family Medicaid applications and periodic renewals.

Basic Considerations

The Non-MAGI budget includes the income of all individuals in the budget group (BG).

A percentage of the Federal Poverty Level (FPL) is used to determine Non-MAGI financial eligibility based on the BG’s net countable income.

Countable income is the BG’s income after deducting the following:

  • $50 child support deduction, if applicable

  • allocated income

  • earned income of a child

  • cost of doing business for self-employed individuals.

Refer to 2655 Family Medicaid Deductions and 2415 Self-Employment. Countable income includes deemed income. Refer to 2661 Responsibility Budgeting (Family Medicaid).

Individuals having financial responsibility in Non-MAGI Medicaid include the following:

  • parents are financially responsible for children

  • spouses are financially responsible for spouses.

Procedures

Follow the steps below to determine eligibility for Non MAGI COAs.

Step 1

Determine the gross countable income of the BG.
Step 2

For self-employed individuals, deduct all allowable Internal Revenue Service (IRS) deductions. Refer to 2415 Self-Employment.
Step 3

Subtract from the gross countable income the following deductions in the order indicated:

  • $50 child support deduction

  • $90 earned income deduction for each employed adult BG member

  • dependent care expenses for each child or incapacitated individual.

Refer to 2655 Family Medicaid Deductions. Deduct any allocated income. Refer to 2661 Responsibility Budgeting (Family Medicaid).
Step 4

Select the appropriate Non-MAGI income limit, a percentage of the Federal Poverty Level (FPL) for the BG size using the criteria below. Refer to Appendix A2, Financial Limits for Family Medicaid.
Step 5

Compare the net countable income to appropriate Non-MAGI income limit for the BG size.

  • If the net countable income is less than or equal to the appropriate Non-MAGI income level, approve the AU members for Non-MAGI Medicaid.

  • If the net countable income exceeds the appropriate Non-MAGI income level for the BG size, the AU members are ineligible for Non-MAGI Medicaid. If ineligible, complete a continuing Medicaid Determination (CMD) for ineligible child(ren) to PeachCare for Kids® (PCK) or the Federally Facilitated Marketplace for ineligible children and adults.