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All County Welfare Directors Letter No.: 20-10 Page 29 April 30, 2020 Spouse 1’s Household Composition: 1) Does Spouse 1 expect to file a federal tax return? Yes. 2) Does Spouse 1 expect to be claimed as a tax dependent by another tax filer? No. 3) Spouse 1 qualifies for Tax Filer Rules: household consists of tax payer, and all others the tax payer claims as a dependent (Spouse 1 only) 4) Is Spouse 2 married? Yes. 5) Are the individual and their spouse living apart and filing separately? No- based on reasonably predictable change in income (Do not include Spouse 2). 6) Is Spouse 1 pregnant? No. 7) Is anyone included in the household pregnant? No. 8) No additional change, end household composition determination here. Medi-Cal Household Spouse 1 Spouse 2 Family Size Spouse 1 Included Not Included 1 Note: For Covered California program eligibility, if the individual states that they are legally married and planning to file as “Married Filing Separately”, they will be ineligible for financial assistance through Covered California. Individuals in these scenarios should consult with a tax advisor for any exceptions to the filing status rules. If you have any questions, or if we can provide further information, please contact Eric Sweeney by phone at (916) 345-8065 or by email at eric.sweeney@dhcs.ca.gov. Original Signed By Sandra Williams, Chief Medi-Cal Eligibility Division