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.

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

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

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 #24 (04/24)