B Modified Adjusted Gross Income (MAGI) Deductions Except Alimony

 

Program

Manual Section

Caretaker Relative (including TMA and Continued Coverage)

Pregnant Woman

Child

Adult

KidsCare

MA609B

 

Procedures

MAGI Adjustments to Gross Income EXCEPT Alimony

When a customer is screening over income for MAGI, take the following steps to identify, verify and enter adjustments from gross income and pre-tax deductions for MAGI eligibility:

Step

Action

1

Is the customer potentially eligible for a program that uses Modified Adjusted Gross Income (MAGI) rules for income eligibility? (Caretaker Relative, Adult, Child, Pregnant Woman, Or KidsCare)

  • If YES, continue to step 2.

  • If NO, STOP. Process the case without the MAGI deduction.

2

Will the deduction reduce the KidsCare premium?

  • If YES, skip to step 4.

  • If NO, continue to step 3.

3

Is the customer eligible without the deduction?

  • If YES, STOP. Process the case

  • If NO, continue to step 4.

4

Go to the Allowed Deductions from Income screen.

5

Choose the expense type(s) from the list of allowed deductions on the screen by clicking on the check-box.

6

Select the household member or members with the expense and enter the amount.

7

Is proof of the deduction in the case file?

  • If YES, skip to step 10.

  • If NO, continue to step 8.

8

Send the customer a Request for Information (RFI) requesting proof of the deduction.

9

Did the customer return the RFI by the due date?

  • If YES, continue to step 10.

  • If NO, STOP. Remove the entry on the Allowed Deductions from Income screen and process the case. The deduction will not be applied.

10

Review any proof the customer has provided.

NOTE     If the proof shows a different deduction amount than what the customer claimed, update the amount in Allowed Deductions from Income.

11

Does the proof show the expense meets the conditions to be an allowed deduction from income (MA609C)?

  • If YES, verify the factor to apply the deduction.

  • If NO, remove the entry on the Allowed Deductions from Income screen. Process the case. The deduction will not be applied.

NOTE     When unable to determine if the deduction is allowed or if there is enough proof, submit a Policy Clarification Request.