Modified Adjusted Gross Income (MAGI) budgeting is used when determining eligibility for an ACA Adult. Refer to manual release #15.19, Modified Adjusted Gross Income (MAGI) Budgeting for Medical, dated 07/29/15 (updated 08/18/15), policy memo, Verifications for Medical Programs, dated 10/03/13 and PM-08-03-00.
To qualify for ACA Adult, the household income must be at or below 138% of the FPL (133% plus a 5% disregard). There is no spenddown for persons in the ACA Adult group.
Verification of income for 30 days prior to the date of application is required for determining medical eligibility.
Determine nonexempt monthly income and financial eligibility using Family Health Plans policy listed in
PM 08-03-00 and PM 15-05-02.
Resources (assets) are exempt for the ACA Adult group.
Note: Persons eligible for ACA Adult are not eligible for medical extensions under Family Assist (FA).