Addendum 2
MAGI Medicaid Subtypes
Medicaid Subtype |
Description |
Post-Medicaid due to excess spousal support |
|
AF |
Family Medicaid |
AL |
Emergency Alien (MAGI) - legal alien or ineligible non-immigrant |
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% FPL and equal to or less than 203% FPL , 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% FPL and equal to or less than 177% FPL , all ages, with insurance. Title 19 funding |
H2 |
CHIP , income above 159% FPL and equal to or less than 177% FPL , all ages, without insurance. Title 21 funding |
HC |
Healthy Child income less than or equal to 159% FPL , 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% FPL |
PC |
Postpartum Coverage, income is above 159% and equal to or less than 200% FPL . Title 19 funding. |
PO |
Postpartum Coverage, income is equal to or less than 201 - 225% FPL. |
PR |
Pregnant Woman Coverage, income is equal to or less than 159% FPL . |
PX |
Pregnant Woman Coverage, income is above 159% and equal to or less than 200%. Title 19 funding |
S1 |
Income is above 124% FPL and equal to or less than 159% FPL , ages 6-18, with Insurance. Title 19 funding |
S2 |
CHIP , 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% FPL , 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 |
MX |
Newly Eligible - Expansion |
XP |
Non-Newly Eligible (verify subtype in MS 816-1 G before using) |
Incarceration Medicaid Subtype |
Description |
BI |
Breast and Cervical Cancer / Ladies First |
CI |
|
EI |
Emergency Alien Incarcerated (MAGI) - legal alien or ineligible non-immigrant |
FI |
Former Foster Care |
KI |
Pregnant Woman |
NI |
|
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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