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. (1) To be eligible for the MAGI Child program, the child must:

   1. (a) Be under the age of 19; and

   2. (b) With the exception of section (3) below, have household income at or below:

      1. (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
      2. (B) 185 percent of the federal poverty level for the applicable family size for an infant under the age of one.
2. (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. (3) To be eligible for the MAGI Child Program, an individual may not:

   1. (a) Be receiving or deemed to be receiving SSI benefits;
   2. (b) Be eligible for Substitute Adoptive Care, MAGI Parent and Caretaker Relative, or MAGI Pregnant Woman programs.
4. (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. (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.

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

History

DMAP 23-2020, amend filed 05/07/2020, effective 05/08/2020
DMAP 24-2016, f. & cert. ef. 6-2-16
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. 1-30-15; ; DMAP 78-2015(Temp), f. & cert. ef. 12-22-15 thru 6-18-16