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All County Welfare Directors Letter No.: 20-10 Page 27 April 30, 2020

6) Is anyone included in the household pregnant? No. 7) No additional change, end household composition determination here. Medi-Cal Household Parent Child Family Size Homeless Youth Not Included Included 1

Note: For Covered California program eligibility, the tax household size cannot be determined. Individuals must attest to be planning to file a tax return in order to be eligible for financial assistance through Covered California.

5) Separated Spouses Married couples who self-attest to planning to file taxes as “Married Filing Jointly,” regardless of whether they are living together in the same home, are required to include both spouses at application, redetermination or change in circumstance when requesting MAGI Medi-Cal coverage (42 C.F.R 435.603(f)(1)). If an individual self- attests to filing taxes as “Married Filing Jointly” and fails to include their spouse on the case the CEW shall deny or discontinue the entire case for failure to complete the determination or redetermination.

The only instance when the CEW shall not deny or discontinue the entire case is when the individual who the applicant/beneficiary files “Married Filing Jointly” with would have no impact on the household composition and whose income counts. For example, if an individual listed as “Married Filing Jointly” resides out of the home and is not a spouse of any of the household members or an unmarried couple are living together, are filing as “Married Filing Jointly,” but have no mutual tax dependents or children under 21. As outlined in ACWDL 15-26, the CEW shall provide specific information the individual failed to provide on the Notice of Action (NOA). When a case is denied or discontinued for this reason, the following snippet shall be included on the NOA to meet this mandate: “You did not provide the information that we asked for. We need you to provide information about all household members living in your home or included on your tax return to see if you can still get Medi-Cal. Please call us or visit your county social services office to give us this information.”

When using the snippet language above, counties shall also reference the following citation: California Code Regulations Title 22 § 50175, 50171 and Title 42 Code of Federal Regulations § 435.603.