Section 405 IAC 2-2.5-1 - DefinitionsAuthority: IC 12-15-21
Affected: IC 12-15-2; IC 12-15-3
Sec. 1.
For purposes of this rule, the following definitions apply:
(1) "Family size" means the number of persons counted as members of an individual's household. In the case of determining the family size of a pregnant woman: (A) the pregnant woman is counted as herself plus the number of children she is expected to deliver for her own eligibility determination; and(B) the pregnant woman is counted as one (1) person in any other assistance group where she is included.(2) "MAGI" or "modified adjusted gross income" means a methodology for how income is counted and how household composition and family size are determined, as specified at 42 CFR 435.603.(3) "MAGI-based income" means income calculated using the same financial methodologies used to determine modified adjusted gross income under 26 U.S.C. 36B(d)(2)(B), which is hereby incorporated by reference, with the following exceptions: (A) An amount received as a lump sum is counted as income only in the month received.(B) Scholarships, awards, or fellowship grants used for education purposes and not for living expenses are excluded from income.(C) American Indian/Alaska Native exceptions. The following are excluded from income: (i) Distributions from Alaska Native Corporations and Settlement Trusts.(ii) Distributions from any property held in trust, subject to federal restrictions, located within the most recent boundaries of a prior federal reservation, or otherwise under the supervision of the United States Secretary of the Interior.(iii) Distributions and payments from rents, leases, rights of way, royalties, usage rights, or natural resource extraction and harvest from any of the following:(AA) Rights of ownership or possession in any lands described in subdivision (ii).(BB) Federally protected rights regarding off-reservation hunting, fishing, gathering, or usage of natural resources.(iv) Distributions resulting from real property ownership interests related to natural resources and improvements: (AA) located on or near a reservation or within the most recent boundaries of a prior federal reservation; or(BB) resulting from the exercise of federally-protected rights relating to such real property ownership interests.(v) Payments resulting from ownership interests in or usage rights to items that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable tribal law or custom.(vi) Student financial assistance provided under the Bureau of Indian Affairs education programs.(4) "MAGI group" refers to individuals whose eligibility is being determined in accordance with the income standards set forth in this rule. This includes, but is not limited to, the following categories of Medicaid assistance: (A) Child under one (1) year of age.(B) Child one (1) to five (5) years of age.(C) Child six (6) to nineteen (19) years of age.(D) Parent or caretaker relative.(F) Adult nineteen (19) to sixty-five (65) years of age.(G) Extension of income-ineligible pregnant women.(H) Individuals between nineteen (19) and twenty-one (21) years of age residing in an inpatient psychiatric facility who would be eligible.(I) Former foster children up to twenty-one (21) years of age.(J) Children one (1) year of age to nineteen (19) years of age (MCHIP).(K) Children's health plan for children from birth to nineteen (19) years of age.(L) Family planning services for women and men.(5) "Non-MAGI group" includes individuals eligible for or receiving services under the following categories of Medicaid assistance: (D) IV-E foster children.(E) Former foster children enrolled as of his or her eighteenth birthday.(G) Children under nineteen (19) years of age with adoptive assistance.(H) Women with breast and cervical cancer.(I) Medicaid for employees with disabilities (MED Works).(J) Medicaid for the medically improved for employees with disabilities.(K) Residential Care Assistance Program related coverage.(L) Qualified Medicare beneficiary.(M) Specified low income Medicare beneficiary.(N) Qualified disabled and working individuals.(O) Qualified individual.(Q) Ongoing transitional medical assistance.(6) "Tax dependent" means an individual for whom another individual claims a deduction for a personal exemption under 26 U.S.C. 152, which is hereby incorporated by reference.Office of the Secretary of Family and Social Services; 405 IAC 2-2.5-1; filed 6/11/2021, 2:35 p.m.: 20210707-IR-405190602FRA