1 MAGI Based Methodologies

Centers for Medicare & Medicaid
Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
S10-MAGI Based Methodologies RU PRA
document
Version 1.0
08/10/2017

Document Number: 166-QSSI-MACPro-PRA-S10-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S10- MAGI Based Methodologies Screenshots..................................................... 1
1.1
1.2
1.3
1.4
1.5

Section A. Household Composition ................................................................. 1
Section B. Household Income ......................................................................... 2
Section B. Household Income – Path 1 ........................................................... 3
Section B. Household Income – Path 2 ........................................................... 4
Section C. Resource Test and Section D. Additional Information (optional) ... 5

List of Figures
Figure 1: Section A- Household Composition.................................................................. 1
Figure 2: Section B .......................................................................................................... 2
Figure 3: Section B- Path 1 ............................................................................................. 3
Figure 4: Section B- Path 2 ............................................................................................. 4
Figure 5: Section C and Section D .................................................................................. 5

List of Tables
No table of figures entries found.

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Section A. Household Composition

1. S10- MAGI Based Methodologies Screenshots
1.1

Section A. Household Composition

Figure 1: Section A- Household Composition

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1.2

Section B. Household Income

Section B. Household Income

Figure 2: Section B

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Section B. Household Income – Path 1

Section B. Household Income – Path 1

Figure 3: Section B- Path 1

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1.4

Section B. Household Income – Path 2

Section B. Household Income – Path 2

Figure 4: Section B- Path 2

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1.5

Section C. Resource Test and Section D. Additional Information (optional)

Section C. Resource Test and Section D. Additional Information
(optional)

Figure 5: Section C and Section D

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