Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 30 - Medicaid for Children, Families, and Affordable Care Act (ACA) Adults › Subchapter 00 - Affordable Coverage Groups › Part 5 - Medicaid MAGI Financial Eligibility Determinations and Verification › Section 210-RICR-30-00-5.5 - Determination of Household Income

Current through June 14, 2024
A. To be eligible
				  for Medicaid using the MAGI standards, an applicant's current monthly household
				  income must meet the standard applicable to the applicant's MACC group when
				  converted to the FPL as shown below:
MACC Groups
FPL Eligibility Threshold
ACA Expansion Adults
One hundred thirty-three percent (133%)
Children and Young Adults
Two hundred sixty-one percent (261%)
Parents and Caretakers
One hundred thirty-six percent (136%)
Pregnant Women
Two hundred fifty-three percent (253%)
B.
				  When calculating whether an applicant is income-eligible for Medicaid under one
				  of these coverage groups, the following factors must be considered: the members
				  of the applicant's household that must be included; types of countable income;
				  current income and reasonably predicted changes; and conversion of monthly
				  income to the FPL standards.
1. Countable
				  household income - The subsection below identifies all forms of countable
				  income included when determining MAGI-based Medicaid eligibility, including
				  those that are specific to Medicaid eligibility only.
a. Adjusted Gross Income (AGI). Adjusted
				  gross income is gross income adjusted by "above-the-line" deductions. AGI
				  includes wages and salaries and income from a broad array of other sources,
				  such as unemployment benefits, alimony, taxable interest, and capital gains.
				  "Above-the-line" deductions are the adjustments people can make to their gross
				  income. These include alimony payments, interest on student loans, and other
				  items that appear on page one (1) of Form 1040. However, they do not include
				  charitable contributions, mortgage interest and other "below-the-line"
				  deductions.
b. Social Security
				  benefits. All Social Security income benefits are considered countable income
				  when using the MAGI standard to determine eligibility for affordable coverage.
				  This includes Social Security benefits that are considered both taxable and
				  non-taxable income for federal tax purposes.
c. Interest Income. Income received from bank
				  accounts, money market accounts, certificates of deposit, and deposited
				  insurance dividends are considered countable taxable income. Additionally,
				  interest on some bonds issued by and used to finance state and local government
				  operations is also counted for the MAGI even though treated as tax-exempt for
				  federal tax purposes.
d. Foreign
				  earned income. Foreign earned income is countable for the MAGI. This includes
				  all income received from sources within a foreign country or countries earned
				  for services when either performed by: a U.S. citizen and a bona fide resident
				  of a foreign country for an uninterrupted period of time that includes an
				  entire tax year; or a U.S. citizen or resident who, during any period of twelve
				  (12) consecutive months, is present in a foreign country for at least three
				  hundred thirty (330) full days during that period.
e. Medicaid specific adjustments to income.
				  Special Medicaid adjustments are as follows:
(1) Taxable lump sum payments (such as gifts,
				  prizes, income and property tax refunds) are counted only in the month
				  received.
(2) Educational
				  scholarships, awards or fellowships used for education purposes are excluded
				  from consideration as income.
(3)
				  Certain types of income for American Indian/Alaska Native persons are
				  excluded.
f. Treatment
				  of other sources of income for Medicaid eligibility are summarized in the table
				  that follows:
MAGI-Based Medicaid Eligibility
								  Rules
Income Source
Treatment of Income
Self-employment income
Counted with deductions for most expenses,
								  depreciation, and business losses
Salary deferrals (flexible spending, cafeteria
								  and 401(k) plans)
Not counted
Child support received
Not counted
Alimony paid
Alimony payments under separation or divorce
								  agreements finalized after December 31, 2018 are not deductible by the payer.
								  Alimony payments under separation or divorce agreement finalized on or before
								  December 31, 2018 continue to be deductible by the payer except when such
								  agreement is modified and when such modification expressly states that alimony
								  is not deductible to the payer or includible in the income of the
								  recipient
Veterans' benefits
Not counted
Workers' compensation
Not counted
Gifts and inheritances
Not counted
TANF and SSI
Not counted
Qualified Lump Sum Income
Winnings less than eighty thousand dollars
								  ($80,000) are counted as income in the month received.
Winnings of at least eighty thousand dollars
								  ($80,000) but less than ninety thousand dollars ($90,000) are counted as income
								  in equal installments over two months.
For every additional ten thousand dollars
								  ($10,000) in winnings over ninety thousand dollars ($90,000), one (1) month is
								  added to the period over which total winnings are divided, in equal
								  installments, and counted as income.
Discharged Student Loan Debt
Not counted
Moving Expenses
Not counted
Alimony Received
Alimony payments under separation or divorce
								  agreements finalized after December 31, 2018 are not included in the income of
								  the recipient. Alimony payments under separation or divorce agreements
								  finalized on or before December 31, 2018 continue to be included in the income
								  of the recipient for the duration of the agreement except when such agreement
								  is modified, when such modification expressly states that alimony is not
								  deductible to the payer or includible in the income of the recipient
Tuition and Fees Deductions
Not counted