Page 18

17

brother—someone other than his spouse or biological, adopted, or stepparent. Therefore, Murray’s AG is determined in accordance with the rules for non- filers and non-dependents. Murray’s AG consists only of himself—although he is living with his brother Mike, Mike is 20, and siblings are only included in the AG of non-filers and non-dependents if they are under the age of 19.

Example 5: Sam, age 6, lives with his parents, Debbie and Duane, and his brother, Tommy, age 4. Duane expects to file a federal tax return. Debbie will not, and Duane cannot claim Debbie as a dependent nor include her in his AG, since the two are not married. Duane will claim both Sam and Tommy as dependents.

Although they are being claimed as dependents, the children fall into the exception of living with both parents who do not expect to file a joint tax return and expect to be claimed only by one parent. Therefore, their AGs are determined in accordance with the rules for non-filers and non-dependents.

Sam’s AG consists of himself, both of his parents, and Tommy, and Tommy’s AG consists of himself, both of his parents, and Sam. Duane’s AG consists of himself and his two sons, since he is a tax filer claiming them. Debbie is a non-filer and non-dependent, so she is subject to those rules. Her AG consists of herself and her two sons, with whom she lives, but it would not include Duane since the two are not married.

3220.15.00 AG DETERMINATION/PREGNANT WOMEN (MED 3)

The policy discussed in this passage refers only to the MAMA and MAGP categories of assistance.

Pregnant women being considered for Medicaid eligibility under MAMA or MAGP are subject to MAGI methodology for determination of household size (AG). If the pregnant woman is a tax filer, her AG is determined in accordance with the rules for tax filers; if she is a tax dependent, her income is determined in accordance with the rules for tax dependents, and if she is neither a filer nor a dependent, her AG will be determined in accordance with those rules.

An unborn child or children can only be counted in the AG of the pregnant woman. The unborn child(ren) cannot be counted as a part of the AG of the father or siblings, even if the father and mother are married and the other children all live together. Additionally, if the pregnant woman is claimed as a dependent, the unborn child(ren) cannot be counted in the AG of the filer that claims her.

Some examples of the AG composition of applicants/recipients eligible under MAMA and MAGP follow.

Example 1: