OAR 410-200-0305
Eligibility Determination Group — MAGI Medicaid/CHIP

When establishing eligibility for MAGI Medicaid/CHIP, each applicant or beneficiary shall have their own Eligibility Determination Group (EDG) determined individually based on the following EDG rules:
(1) Tax filer EDG:
(a) For individuals who intend to file a federal income tax return, who are not claimed as a tax dependent by another individual, the EDG consists of:
(A) The tax filer;
(B) The tax filer’s spouse, with the following considerations:
(i) If living together, the tax filer’s spouse is included in the EDG of the tax filer, irrespective of the spouse’s tax filing status; and
(ii) If living separately, the tax filer’s spouse is included in the EDG of tax filer if they intend to claim a tax filing status of Married Filing Jointly.
(C) All individuals whom the tax filer intends to claim as tax dependents.
(b) For tax filers who expect to be claimed as a tax dependent by another individual, the EDG is determined in accordance with section (2).
(2) Tax dependent EDG:
(a) Except as described in subsection (b) of this part, the EDG of an individual who expects to be claimed as a tax dependent is the same as the EDG of the tax filer who intends to claim them, as outlined in section (1) of this rule.
(b) For tax dependents who meet any of the following exceptions, the EDG is determined in accordance with section (3) of this rule:
(A) The individual is claimed as a tax dependent by someone other than a parent or spouse;
(B) The individual is a child living with both parents but is claimed as a tax dependent by one parent; or
(C) The individual is a child living with a parent and is claimed as a tax dependent by a non-custodial parent.
(3) Non-filer EDG:
(a) An individual’s EDG is determined in accordance with this section if:
(A) The individual does not expect to file a tax return and is not claimed as a tax dependent;
(B) The individual does not expect to file a tax return and cannot substantiate whether or not they will be included in the tax return of another individual; or
(C) The individual expects to be claimed as a tax dependent and meets an exception described in section (2)(b) of this rule.
(b) The non-filer EDG consists of the following individuals, if living in the same household:
(A) The individual;
(B) The individual’s spouse;
(C) The individual’s children; and
(D) If the individual is a child, their parents and child siblings;
(c) Individuals described in subsection (b) of this part are still considered EDG members if they are temporarily absent from the household with intent to return to the household when the purpose of their absence is complete. Reasons for temporary absence include but are not limited to:
(A) Education;
(B) Military;
(C) Work or training;
(D) Incarceration; or
(E) Hospitalization.

Source: Rule 410-200-0305 — Eligibility Determination Group — MAGI Medicaid/CHIP, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-200-0305.

410–200–0010
Overview 410–200–0015
General Definitions 410–200–0100
Coordinated Eligibility and Enrollment Process with the Department of Human Services and the Federally Facilitated Marketplace 410–200–0105
Hospital Presumptive Eligibility 410–200–0110
Application and Renewal Processing and Timeliness Standards 410–200–0111
Authorized Representatives 410–200–0115
HSD Medical Programs—Effective Dates 410–200–0120
Notices 410–200–0125
Acting on Reported Changes 410–200–0130
Retroactive Medical 410–200–0135
Assumed, Continuous, and Protected Eligibility for Children and Pregnant Individuals 410–200–0140
Eligibility for Inmates 410–200–0145
Contested Case Hearing 410–200–0146
Final Orders, Dismissals and Withdrawals 410–200–0200
Residency Requirements 410–200–0205
Concurrent and Duplicate Program Benefits 410–200–0210
Requirement to Provide Social Security Number 410–200–0215
Citizenship and Non-Citizen Status Requirements 410–200–0220
Requirement to Pursue Assets 410–200–0225
Assignment of Rights 410–200–0230
Verification 410–200–0235
Changes That Must Be Reported 410–200–0240
Eligibility for Individuals Who Do Not Meet the Citizen and Non-Citizen Status Requirements 410–200–0305
Eligibility Determination Group — MAGI Medicaid/CHIP 410–200–0310
Eligibility and Budgeting 410–200–0315
Standards and Determining Income Eligibility 410–200–0400
Specific Requirements 410–200–0405
Specific Requirements 410–200–0407
Specific Requirements—Former Foster Care Youth Medical Program 410–200–0410
Specific Requirements 410–200–0415
Specific Requirements 410–200–0420
Specific Requirements 410–200–0425
Specific Requirements 410–200–0435
Specific Requirements 410–200–0440
Specific Requirements 410–200–0520
COVID-19 Emergency Policies
Last Updated

Jun. 8, 2021

Rule 410-200-0305’s source at or​.us