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All County Welfare Directors Letter No.: 20-10 Page 3 April 30, 2020
different household composition than others on the same case. Unlike other Medi-Cal programs, beneficiaries of SSI/SSP, CalWORKS, or those in long-term care should be included, when appropriate, into an individual’s MAGI household composition.
The CEW shall determine the individual’s MAGI household composition based on the following tax filing status rules as referenced in 42 C.F.R. Section 435.603: • Tax Filer Rules; • Tax Dependent Rules; • Tax Dependent Exceptions; and • Non-Filer Rules.
Note: Household composition methodology for Covered California programs is based on tax filing rules found in 26 C.F.R. Section 1.36B-1 and should not be confused with MAGI Medi-Cal household composition methodology.
Tax Filer Rules Tax Filer Rules apply to individuals who expect to file a federal tax return and another tax filer does not claim them as a tax dependent for the year in which MAGI Medi-Cal is sought. As defined in 42 C.F.R. Section 435.603(f)(1) and (4), the household composition of a tax filer not claimed as a tax dependent shall consist of: 1) The tax filer; 2) The spouse of the tax filer who lives in the home, regardless of whether they are filing a joint return; 3) Married couples who are living together (Note: this group is always in each other’s household regardless of how they file); 4) The spouse of tax filer who files “Married Filing Jointly” but who does not live in the home; 5) Everyone the tax filer claims as a tax dependent, regardless of whether they reside in the home of the tax filer; and/or 6) The unborn child(ren) of the pregnant tax filer, the unborn child(ren) of the pregnant spouse if living in the home or filing taxes as “Married Filing Jointly”, or the unborn child(ren) of a pregnant tax dependent in the individual’s household composition.
It is possible for some individuals to claim tax dependent(s) that do not reside in the home, including dependents that reside in another country. The CEW shall include all