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2 TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE • Is a child, stepchild, foster child, brother, sister, stepbrother, step-sister, or a descendant of any of them, • Lived with claiming tax filer for more than half of the year, • Didn’t provide more than half of his or her own support for the year, • Was under age 19 at the end of the year and younger than the claiming tax filer (or spouse if filing jointly), or was under age 24 at the end of the year, a student, and younger than the tax filer (or spouse if filing jointly), or was any age and permanently and totally disabled, and didn’t file a joint return with his or her spouse. For more information, see Exemptions for Dependents in IRS Pub 501. "Qualifying relative" To be a dependent, a person must be either a qualifying child or a qualifying relative. Generally, a person is a qualifying relative if that person: • Lives with or is related to the taxpayer claiming him or her, • Has gross income at or below the Qualifying Relative income limit found in IRS Pub 501 (which may change annually), • Is supported (generally more than 50%) by the taxpayer claiming him or her, and • Is neither a qualifying child nor a qualifying child of anyone else For more information, see Exemptions for Dependents in IRS Pub. 501 "Sibling" means a natural or biological, adopted, half, or step-sibling. "Spouse" means a person who is legally married to another person regardless of their genders. "Tax dependent" means a person, other than the tax filer or the tax filer’s spouse, for whom an exemption can be claimed. To be a dependent, a person must be a qualifying child or qualifying relative of the tax filer. For more information, see Exemptions for Dependents in IRS Pub 501. 17 DE Reg. 731 (01/01/14) 22 DE Reg. 668 (02/01/19) 24 DE Reg. 1072 (06/01/21) 29 DE Reg. 212 (09/01/25) 16200 Application of MAGI income and household size Eligibility for an applicant shall be based on MAGI methodology effective January 1, 2014. Ongoing eligibility for a beneficiary determined eligible for Medicaid coverage to begin on or before December 31, 2013, shall not have eligibility based on MAGI methodology until March 31, 2014, or at the next regularly scheduled renewal of eligibility, whichever is later. If the household income of an individual determined in accordance with this section results in financial ineligibility for Medicaid and the household income of the individual determined in accordance with 26 CFR 1.36B-1(e) is below 100% of the Federal Poverty Level (FPL), Medicaid financial eligibility will be determined in accordance with 26 CFR 1.36B-1(e) as promulgated the IRS. This is the income-counting methodology used by the Federally Facilitated Marketplace (FFM) to determine eligibility for Advance Premium Tax Credits and Cost Sharing Reductions. 16300 MAGI-based Determination of Eligibility Each applicant or beneficiary who meets the non-financial eligibility requirements will have a determination of eligibility based on MAGI methodology. For an applicant or beneficiary found not eligible based on MAGI methodology and who has been identified on the application or renewal form as potentially eligible on a MAGI-excepted basis, an eligibility determination will be made on such basis. An individual may request a determination of eligibility on a basis other than MAGI. 16400 Household Composition Household composition is based on tax households, with certain exceptions. 16400.1 Basic rule for taxpayer not claimed as a tax dependent For an individual who expects to file a tax return for the taxable year in which an initial determination or renewal of eligibility is being made, and who does not expect to be claimed as a tax dependent by another taxpayer, the household consists of: the taxpayer; a spouse living with the taxpayer; and all persons whom the taxpayer expects to claim as a tax dependent. If a taxpayer cannot reasonably establish that another individual is a tax dependent for the tax year in which Medicaid is sought, the inclusion of the dependent in the taxpayer’s household shall be determined according to the rules described at Section 16400.3, Rule for individuals who neither file a tax return nor are claimed as a tax dependent.