In addition to eligibility requirements applicable to the MAGI
Child program in other rules in chapter 410 division 200, this rule describes
specific eligibility requirements for the MAGI Child program.
(1) To be eligible for the MAGI Child
program, the child must:
(a) Be under the age
of 19; and
(b) With the exception
of section (3) below, have household income at or below:
(A) 133 percent of the federal poverty level
(OAR
410-200-0315) for the applicable
family size for a child over the age of one but less than age 19; or
(B) 185 percent of the federal poverty level
for the applicable family size for an infant under the age of one.
(2) A child born to an
individual who is eligible for and receiving Medicaid/CHIP benefits is an
Assumed Eligible Newborn (AEN) for the MAGI Child program until the end of the
month in which the child turns one year of age (see OAR
410-200-0135). There is no
income limit for an AEN.
(3) To be
eligible for the MAGI Child Program, an individual may not:
(a) Be receiving or deemed to be receiving
SSI benefits;
(b) Be eligible for
Substitute Adoptive Care, MAGI Parent and Caretaker Relative, or MAGI Pregnant
Woman programs.
(4) To
enroll a child in the MAGI Child program based on a determination made by an
Express Lane Agency (ELA), the child's parent or guardian shall give consent in
writing, by telephone, orally, or through electronic signature.
(5) ELE qualifies a child for medical
assistance benefits based on a finding from the Department, even when the
Department's eligibility methodology differs from that used for HSD Medical
Programs.
Notes
Or. Admin. Code
§
410-200-0415
DMAP 54-2013(Temp), f.
& cert. ef. 10-1-13 thru 3-30-14; DMAP 4-2014(Temp), f. & cert. ef.
1-15-14 thru 3-30-14; DMAP 20-2014, f. & cert. ef. 3-28-14; DMAP
67-2014(Temp), f. 11-14-14, cert. ef. 11-15-14 thru 5-13-15;
DMAP
3-2015, f. & cert. ef.
1/30/2015; DMAP 78-2015(Temp), f. & cert.
ef. 12-22-15 thru 6-18-16;
DMAP
24-2016, f. & cert. ef.
6/2/2016;
DMAP
23-2020, amend filed 05/07/2020, effective
5/8/2020
Statutory/Other Authority: ORS
411.402,
411.404 &
413.042
Statutes/Other Implemented: ORS
411.400,
411.402,
411.404,
411.406,
411.439,
411.443,
413.032,
413.038,
414.025,
414.231, 414.447 &
414.706
