what is magi medicaid

MAGI Medicaid, which stands for Modified Adjusted Gross Income Medicaid, is a method for determining eligibility for Medicaid based on federal income tax rules. It is used to evaluate eligibility for Medicaid and other health insurance programs, such as the Childrens Health Insurance Program (CHIP) and Marketplace health insurance plans. The MAGI methodology follows the same rules as when a household files their federal income taxes and is based on the adjusted gross income that a filing unit reports on their federal income tax return with certain modifications. Recipients in the MAGI group are eligible for "benchmark benefits," which cover everything that Medicaid otherwise covers except long-term care in an institution, such as a nursing home. MAGI Medicaid is used to determine household composition, household size, and how income is counted to evaluate eligibility for Medicaid. It applies to certain populations, such as low-income singles, childless couples, pregnant women, and children under 19. The MAGI rules generally do not apply to people over age 65 or those who have Medicare, with limited exceptions. MAGI Medicaid has brought significant changes to Medicaid eligibility rules, particularly for certain populations, as a result of the Affordable Care Acts eligibility expansion and streamlining provisions.