Addendum-2 MAGI Medicaid Subtypes

Modified Adjusted Gross Income Medicaid

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Addendum 2

MAGI Modified Adjusted Gross Income Medicaid Subtypes

Medicaid Subtype	Description
4MFour Month Post-Medicaid Eligibili	Post-Medicaid due to excess spousal support Modif
AF	Family Medicaid
AL	Emergency Alien (MAGI) - legal alien or ineligible non-immigrant
BABaby Medi	Newborn - through month of 1st birthday (child born to a woman who was eligible for Medicaid in the month of delivery)
CP	CHIP, income above 177% FPLFederal Poverty Limit and equal to or less than 203% FPLFederal Poverty Limit, all ages, without insurance. Title 21 funding
FC	Title IV-E Foster Care child in State custody
FF	Former Foster Care Children under age 26
H1	Income above 159% FPLFederal Poverty Limit and equal to or less than 177% FPLFederal Poverty Limit, all ages, with insurance. Title 19 funding
H2	CHIP Children's Health Insurance Program, income above 159% FPLFederal Poverty Limit and equal to or less than 177% FPLFederal Poverty Limit, all ages, without insurance. Title 21 funding
HC	Healthy Child income less than or equal to 159% FPLFederal Poverty Limit, age 0-5, with and without insurance. Title 19 funding
IP	Under 21 child in State custody & In-Patient Psychiatric
IV	Title IV-E Subsidized Adoption
JC	Juvenile Court Ordered Child in State custody
PB	Postpartum Coverage, income is equal to or less than 159% FPLFederal Poverty Limit
PC	Postpartum Coverage, income is above 159% and equal to or less than 200% FPLFederal Poverty Limit. Title 19 funding.
PO	Postpartum Coverage, income is equal to or less than 201 - 225% FPL.Federal Poverty Limit
PR	Pregnant Woman Coverage, income is equal to or less than 159% FPLFederal Poverty Limit.
PV	Pregnant Woman Coverage, income is above 200% and equal to or less than 225%. Title 19 funding
PX	Pregnant Woman Coverage, income is above 159% and equal to or less than 200%. Title 19 funding
S1	Income is above 124% FPLFederal Poverty Limit and equal to or less than 159% FPLFederal Poverty Limit, ages 6-18, with Insurance. Title 19 funding
S2	CHIP Children's Health Insurance Program, income is above 124% and equal to or less than 159%, ages 6-18 without insurance. Title 21 funding
SO	State-only (not IV-E) subsidized adoption (State custody)
SU	Six Up, income is equal to or less than 124% FPLFederal Poverty Limit, ages 6-18, with or without insurance. Title 19 funding
T1	Transitional Medicaid
TO	Under 21
UA	Emergency Alien (MAGI) - undocumented illegal alien only
VO	Child in voluntary state custody

Expansion Medicaid

Subtype

Description

Newly Eligible - Expansion

Non-Newly Eligible (verify subtype in MS 816-1 G before using)

Incarceration Medicaid Subtype	Description
BI	Breast and Cervical Cancer / Ladies First
CI	DKCDenali KidCare CHIP Children's Health Insurance Program/Title 21 funding (Subtypes S2, H2, and CP)
EI	Emergency Alien Incarcerated (MAGI) - legal alien or ineligible non-immigrant
FI	Former Foster Care
KI	Pregnant Woman
NI	DKCDenali KidCare non-CHIP Children's Health Insurance Program/Title 19 funding (subtypes BA, HC, H1, SU)
TI	Under 21
MI	Newly Eligible - Expansion
UI	Emergency Alien Incarcerated (MAGI) - undocumented illegal alien only
XI	Non-Newly Eligible (verify subtype in MS 816-1 G before using)

The following Medicaid eligibility codes are specific to MAGI Medicaid unless there is a “*”in the description

Medicaid Eligibility Code	Description
11	Pregnant Woman *
20	No other eligibility codes apply *
31	Adults with Physical and Developmental Disabilities Waiver *
41	Alaskans Living Independently Waiver *
50	Child Under 21 and not in state custody (including subsidized adoptions)
51	Child Under 21 and in state custody (including Title IV-E Foster Care)
52	4 month Post-MAGI Medicaid eligibility (increased spousal support)
53	Ineligible Alien Emergency coverage (used for everyone except pregnant women)*
71	Intellectual and Developmental Disability Waiver *
81	Complex Medical Condition Waiver *
92	Individualized Supports Waiver *
93	Individualized Supports Waiver – Pregnant*

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		MC #28 (09/25)