(1) The agency uses the modified adjusted gross income (MAGI) methodology to determine eligibility for MAGI-based Washington apple health (((WAH))) programs described in WAC 182-509-0305.

(2) MAGI methodology is described in WAC 182-509-0300 through 182-509-0375. Generally, MAGI includes adjusted gross income (as determined by the Internal Revenue Code (IRC)) increased by:

(a) Any amount of foreign income excluded from gross income under Section 911 of the IRC;

(b) Any amount of interest received or accrued by the taxpayer during the taxable year which is exempt from tax; and

(c) Any amount of Title II Social Security income or Tier 1 Railroad Retirement income which is excluded from gross income under Section 86 of the IRC.

(3) When calculating a person's eligibility for the programs listed in WAC 182-509-0305, the agency uses the person's MAGI income with the following exceptions:

(a) Scholarships or fellowship grants described in WAC 182-509-0335 used for education purposes are excluded from income;

(b) Income received by American Indian/Alaskan Native individuals described in WAC 182-509-0340 is excluded from income; ((and))

(c) Any income received as a lump sum as described in WAC 182-509-0375 is counted as income only in the month in which it is received; and

(d) Income received by a child age eighteen or younger or a tax dependent as described in WAC 182-509-0360 is excluded from income.

(4) Countable MAGI income is reduced by an amount equal to five percentage points of the federal poverty level (FPL) based on household size to determine net income except that there is no such reduction of countable MAGI income for parents or caretaker relatives with an eligible dependent child ((whose net countable income is below fifty-four percent of the FPL)) (as described in WAC 182-509-0305(1)). Net income is compared to the applicable standard described in WAC 182-505-0100.

(5) When calculating a person's eligibility for MAGI-based programs listed in WAC 182-509-0305, the agency determines the medical assistance unit for each person according to WAC 182-506-0010 and 182-506-0012.

For purposes of determining eligibility for modified adjusted gross income (MAGI)–based Washington apple health (((WAH))) (see WAC 182-509-0300):

(1) Some types of income are not counted when determining eligibility for MAGI-based ((WAH))apple health. Under the MAGI income methodology described in WAC 182-509-0300, income is not counted if the Internal Revenue Service (IRS) permits it to be excluded or deducted for purposes of determining the tax liability of a person. (See 26 U.S.C. Sections 62(a) and 101-140.)

(2) Examples of income that are not counted include, but are not limited to:

(a) Bona fide loans, except certain student loans as specified under WAC 182-509-0335;

(b) Federal income tax refunds and earned income tax credit (((EITC))) payments for up to twelve months from the date received;

(c) Child support payments received by any person included in household size under WAC 182-506-0010;

(d) Nontaxable time loss benefits or other compensation received for sickness or injury, such as benefits from the department of labor and industries (L&I) or a private insurance company;

(e) Title IV-E and state foster care and adoption support maintenance payments;

(f) Veteran's benefits including, but not limited to, disability compensation and pension payments for disabilities paid to the veteran or family members; education, training and subsistence; benefits under a dependent-care assistance program for veterans, housebound allowance and aid and attendance benefits;

(g) ((Educational assistance that is not counted under WAC 182-509-0335;

(k))) Money withheld from a benefit to repay an overpayment from the same income source;

(((l)))(h) One-time payments issued under the Department of State or Department of Justice reception and replacement programs, such as Voluntary Agency (VOLAG) payments;

(((m)))(i) Nontaxable income from employment and training programs;

(j) Any portion of income used to repay the cost of obtaining that income source;

(((n) Insurance proceeds or other income received as a result of being a Holocaust survivor;

(o)))(k) Insurance proceeds or other income received as a result of being a Holocaust survivor;

(l) Federal economic stimulus payments that are excluded for federal and federally assisted state programs;

(((p) Federal twenty-five dollar supplement weekly unemployment compensation payment authorized by the American Recovery and Reinvestment Act of 2009;

(q)))(m) Income from a sponsor given to a sponsored immigrant;

(((r) Energy assistance payments;

(s)))(n) Fringe benefits provided on a pretax basis by an employer, such as transportation benefits or moving expenses;

(((t)))(o) Employer contributions to certain pretax benefits funded by an employee's elective salary reduction, such as amounts for a flexible spending account;

(((u)))(p) Distribution of pension payments paid by the employee (such as premiums or contributions) that were previously subject to tax;

(((v) Gifts or inheritances to the person that are not counted under WAC 182-509-0355;

(w)))(q) Gifts as described in IRS Publication 559: Survivors, Executors, and Administrators;

(s) Death benefits from life insurance and certain benefits paid for deaths that occur in the line of duty; and

(((x)))(t) Other payments that are excluded from income under state or federal law.

(3) Income received from ((the following cash programs is not countable income for MAGI-based WAH))other agencies or organizations as needs-based assistance is not countable income under this section.

(b) Needs-based cash programs include, but are not limited to, the following apple health programs:

(((a)))(i) Diversion cash assistance (DCA);

(((b)))(ii) Temporary assistance for needy families (TANF);

(((c)))(iii) State family assistance (SFA);

(((d)))(iv) Pregnant women's assistance (PWA);

(((e)))(v) Refugee cash assistance (RCA);

(((f)))(vi) Aged, blind, disabled cash assistance (ABD); and

(((g)))(vii) Supplemental security income (SSI).

For purposes of determining eligibility for modified adjusted gross income (MAGI)–based Washington apple health (((WAH))) (see WAC 182-509-0300), the agency or its designee does not count educational ((assistance))benefits as income when they are used for education expenses, unless the educational benefits are used for living expenses. Examples include, but are not limited to:

(1) Educational assistance in the form of grants or loans issued under Title IV of the Higher Education Amendments (Title IV - HEA) or through a program administered by the Department of Education (DOE), such as:

(a) Pell grants (Title IV);

(b) Stafford loans (Title IV);

(c) Perkins loan program (Title IV);

(d) State need grant program (Title IV);

(e) ((Christa McAuliffe fellowship program (DOE);

(g) Library career))Training programs administered by the Department of Education (DOE).

(2) Payments received for education, training, or subsistence under any law administered by the department of Veteran's Affairs (VA).

(3) Student financial assistance provided under the Bureau of Indian Affairs education programs.

(4) Educational assistance in the form of grants or loans under the Carl D. Perkins Vocational and Applied Technology Education Act, P.L. 101-392.

(5) Work study income including:

(a) Federal or state work study income; and

(b) WorkFirst work study income.

(6) Payments to service academy cadets at a military academy.

(7) Payments for the purposes of tuition made on behalf of the individual to an educational organization for the education or training of such individual.