Oregon Administrative Rules
Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS
Division 200 - ELIGIBILITY FOR HEALTH SYSTEMS DIVISION MEDICAL PROGRAMS
Section 410-200-0436 - Specific Requirements: MAGI Expanded Adult Program

Universal Citation: OR Admin Rules 410-200-0436

Current through Register Vol. 63, No. 9, September 1, 2024

(1) The Modified Adjusted Gross Income (MAGI) Expanded Adult program is effective April 1, 2023.

(2) Individuals who lose eligibility for other OHP Plus medical benefits due to an increase of countable income may be eligible for the MAGI Expanded Adult program if they:

(a) Are 19 years of age or older and under age 65;

(b) Have household income greater than 138 percent federal poverty level through 200 percent federal poverty level (OAR 410-200-0315) for the applicable family size;

(c) Meet citizenship or non-citizen status requirements outlined in OAR 410-200-0215;

(d) Are not entitled to or enrolled in Medicare benefits under part A or B of Title XVIII of the Act; and

(e) Are not receiving SSI benefits.

(3) As a condition of MAGI Expanded Adult program eligibility for parents or caretaker relatives with a dependent child living in the home, the child must be enrolled in minimum essential coverage.

(4) The MAGI Expanded Adult program is not available to new applicants or individuals reapplying after a break in coverage.

(5) The MAGI Expanded Adult program is not subject to protected eligibility provisions related to pregnancy, described in OAR 410-200-0135 - Assumed, Continuous, and Protected Eligibility for Children and Pregnant Individuals section (3).

(6) The MAGI Expanded Adult program eligibility is not subject to the pursuit of assets requirements found in OAR 410-200-0220 - Requirement to Pursue Assets.

Statutory/Other Authority: 42 CFR 435.110, ORS 435.112, 435.115, 435.116, 435.118, 435.403, 435.940, 435.1200, 457.80, 457.340, 458.350, 435.3, 435.4, 435.406, 435.407, 435.952, 435.956, 435.1008, 457.320, 457.380, 435.608, 433.138, 433.145, 433.146, 433.147, 433.148, 435.117, 435.119, 435.1205, 435.170, 435.190, 435.222, 435.610, 435.916, 435.917, 447.56, 457.350, 457.360, 457.805, ORS 411.402, 411.404, 413.042 & 414.534

Statutes/Other Implemented: ORS 411.402, 411.404, ORS 411.060, 411.095, 411.400, 411.406, 411.439, 411.443, 413.032, 413.038, 414.025, 414.231, 414.440, 414.534, 414.536 & 414.706

Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.