Idaho Administrative Code
Title IDAPA 16 - Health and Welfare, Department of
Rule 16.03.01 - ELIGIBILITY FOR HEALTH CARE ASSISTANCE FOR FAMILIES AND CHILDREN
Section 16.03.01.011 - DEFINITIONS (M THROUGH Z)
Current through August 31, 2023
For the purposes of this chapter, the following terms apply. (3-17-22)
01. MAGI-Based Income. Income calculated using the same financial methodologies used by the IRS to determine modified adjusted gross income for federal tax filers, with the exception that: (3-17-22)
02. Medicaid. Idaho's Medical Assistance Program administered by the Department and funded with federal and state funds according to Title XIX of the Social Security Act that provides medical care for eligible individuals. (3-17-22)
03. Modified Adjusted Gross Income (MAGI). Modified Adjusted Gross Income (MAGI), is Adjusted Gross Income as defined by the IRS, plus certain tax-exempt income. (3-17-22)
04. Newborn Deemed Eligible. A child born to a woman who is eligible for and receiving medical assistance on the date of the child's birth, including during a month of retroactive eligibility for the mother. A child so born is eligible for Medicaid for the first year of his life. (3-17-22)
05. Non-Citizen. Same as "alien" defined in Section 101(a)(3) of the Immigration and Nationality Act (INA) (8 U.S.C. 1101(a)(3)), and includes any individual who is not a citizen or national of the United States. (3-17-22)
06. Parent. For a household with a MAGI-based eligibility determination a parent can be: (3-17-22)
07. Participant. An individual who is eligible for, and enrolled in, a Health Care Assistance program. (3-17-22)
08. Qualified Hospital. A qualified hospital has a Memorandum of Understanding (MOU) with the Department, participates as a provider under the Medicaid state plan, may assist individuals in completing and submitting applications for Health coverage, and has not been disqualified from doing presumptive eligibility determinations. (3-17-22)
09. Qualified Non-Citizen. Same as "qualified alien" defined at 8 U.S. C. 164(b) and (c). (3-17-22)
10. Reasonable Opportunity Period. A period of time allowed for an individual to provide requested proof of citizenship or identity. A reasonable opportunity period extends for ninety (90) days beginning on the 5th day after the notice requesting the proof has been mailed to the applicant. This period may be extended if the Department determines that the individual is making a "good faith" effort to obtain necessary documentation. (3-17-22)
11. Sibling. For household with MAGI-based eligibility determination: Is a natural or biological, adopted, half- or step-sibling. (3-17-22)
12. Tax Dependent. A person, who is a related child, or other qualifying relative or person, according to federal IRS standards for whom another individual can claim a deduction for a personal exemption when filing a federal income tax for a taxable year. (3-17-22)
13. Third Party. Includes a person, institution, corporation, public or private agency that is liable to pay all or part of the medical cost of injury, disease, or disability of a medical assistance participant. (3-17-22)
14. Title XIX. Title XIX of the Social Security Act, known as Medicaid, is a medical benefits program jointly financed by the federal and state governments and administered by the States. This program pays for medical assistance for certain individuals and families with low income, and for some program types, limited resources. (3-17-22)
15. Title XXI. Title XXI of the Social Security Act, known as the Children's Health Insurance Program (CHIP), is a federal and state partnership similar to Medicaid, that expands health insurance to targeted, low-income children. (3-17-22)
