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MAGI Medicaid for Adults, Children, & Families

What does MAGI mean? 

  • MAGI stands for Modified Adjusted Gross Income
  • MAGI-based budgeting is used to calculate a person's household size and income, using federal income tax rules and a tax filer's family size to determine eligibility for Medicaid
  • The MAGI Medicaid program started January 1, 2014, as part of the Affordable Care Act (ACA)

Who is potentially eligible for MAGI Medicaid?

  • Single,  childless adults
  • Married, childless couples
  • Families with children ages 19 and under
  • Children up to age 19

What are the income guidelines?

It depends.  There are different categories of MAGI Medicaid.  All guidelines are based on gross (before taxes) income:

  • Parents and Caretaker Relatives (grandparents raising grandchildren, aunts raising nieces/nephews, etc.):  up to 90% of the federal poverty level for their household size
  • Expansion Adults (all adults, including Parents and Caretaker Relatives who are not eligible at the step above): up to 133% of the federal poverty level for their household size
  • Children with Insurance:  up to 156% of the federal poverty level for their household size
  • Pregnant Women:  up to 200% of the federal poverty level for their household size
  • Children without Insurance:  up to 206% of the federal poverty level for their household size

Below is a chart showing the 2019 standards for MAGI Medicaid eligibility: 

Medicaid HH Size

Parents & Caretakers

Expansion Adults

Children with Insurance

Pregnant Women

Children without Insurance

1

$911

$1346

$1579

$2024

$2085

2

$1235

$1825

$2140

$2744

$2826

3

$1559

$2304

$2702

$3464

$3568

4

$1883

$2782

$3263

$4184

$4309

5

$2207

$3261

$3825

$4904

$5051

6

$2531

$3740

$4387

$5624

$5793

7

$2855

$4219

$4948

$6344

$6534

8

$3179

$4698

$5510

$7064

$7276

How do I apply for MAGI Medicaid?

Where can I go for more information?

  • Ohio Department of Medicaid's Frequently Asked Questions page
  • Call the Medicaid Consumer Hotline at 1-800-324-8680
  • If you currently have an open MAGI Medicaid case in Lorain County and have a specific question regarding your individual case, call the LCJFS Call Center at (440) 284-4300

 

 

 

Medicaid