Section R9-22-1420. Income Eligibility Criteria

A.      Evaluation of income. In determining eligibility, the Adminis- tration or its designee shall evaluate the following types of income received by a person identified in subsection (B):

1.        Earned income, including in-kind income, before any deductions. For purposes of this Section, in-kind income means room, board, or provision for other needs in exchange for work performed. The person identified in subsection (B) shall ensure that the provider of the in- kind income establishes and verifies the monetary value of the item provided. The provider may be, but is not lim- ited to:

a.         A landlord who provides all or a portion of rent or utilities in exchange for services;

b.        A store owner who gives goods such as groceries, clothes, or furniture in exchange for services; or

c.         An individual who trades goods such as a car, tools, trailer, building material, or gasoline in exchange for services;

2.        Self-employment income under R9-22-1424, including gross business receipts minus business expenses; and

3.        Unearned income, including deemed income under R9- 22-317 from the sponsor of a non-citizen applicant.

B.       MAGI income group. The Administration or its designee shall include the following persons in the MAGI income group:

1.        When the applicant is a taxpayer include:

a.         The applicant,

b.        Everyone the applicant expects to claim as a tax dependent for the current year, and

c.         The applicant’s spouse, when living with the appli- cant.

2.        Except as provided in subsection (B)(3), when the appli- cant expects to be claimed as a tax dependent for the cur- rent year include:

a.         The taxpayer claiming the applicant,

b.        Everyone else the taxpayer expects to claim as a tax dependent,

c.         The taxpayer’s spouse when living with the tax- payer, and

d.        The applicant’s spouse, when living with the appli- cant.

3.        When any of the following apply, determine the persons whose income is included as described in subsection (4)(a) or (4)(b) based on the applicant’s age:

a.         The applicant expects to be claimed as a tax depen- dent by someone other than a spouse or natural, adopted or step-parent;

b.        The applicant is under age 19, expects to be claimed as a tax dependent by a natural, adopted or step-par- ent, lives with more than one such parent and the parents do not expect to file a joint tax return; or

c.         The applicant is under age 19 and expects to be claimed as a tax dependent by a non-custodial par- ent.

4.        When the applicant is not a taxpayer, does not expect to be claimed as a tax dependent and is:

a.         Under age 19. Include the income of the applicant and when living with the applicant, the applicant’s:

i.         Spouse;

ii.        Natural, adopted and step-children;

iii.      Natural, adopted and step-parents;

iv.       Natural, adopted and step-siblings; and

b.        Age 19 or older. Include the income of the applicant and when living with the applicant, the applicant’s:

i.         Spouse;

ii.        Natural, adopted and step-children under age 19.

5.        When the applicant is a pregnant woman, the Administra- tion or its designee  shall also include the number of expected babies only for the pregnant woman’s income group.

6.        When the taxpayer cannot reasonably establish that a per- son is the taxpayer’s tax dependent, inclusion of the per- son in the taxpayer’s MAGI income group is determined as provided in subsection (B)(4).

C.      A person whose income is counted. The Administration or its designee shall count the MAGI-based income of all members of an applicant’s MAGI income group with  the  following exceptions:

1.        The income of an individual who is included in the MAGI income group of his or her natural, adoptive or step parent and is not expected to be required to file a tax return for the year in which eligibility for Medicaid is being determined, is not counted whether or not the indi- vidual files a tax return.

2.        The income of a tax dependent other than the taxpayer’s spouse or biological, adopted or stepchild who is not expected to be required to file a tax return for the year in which eligibility for Medicaid is being determined is not counted when the tax dependent is included in the tax- payer’s MAGI  income group,  whether  or not the  tax dependent files a tax return.

Historical Note

New Section adopted by final rulemaking at 5 A.A.R. 294, effective January 8, 1999 (Supp. 99-1). Section repealed; new Section made by exempt rulemaking at 7

A.A.R. 4593, effective October 1, 2001 (Supp. 01-3).

Section repealed; new Section made by final rulemaking at 11 A.A.R. 4942, effective December 31, 2005

(Supp. 05-4). Amended by final rulemaking at 20 A.A.R.

192, effective January 7, 2014 (Supp. 14-1).