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REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-006

477-000-006 – Determination of Medicaid Budgeting Procedures

Determining MAGI-Based Eligibility

1. CONSTRUCT A MEDICAID/CHIP HOUSEHOLD FOR EACH APPLICANT.

A. Does the individual expect to file taxes? i. If no – continue to Step B. ii. If yes – does the individual expect to be claimed as a tax dependent by anyone else? 1. If no – the household consists of the taxpayer, a spouse living with the taxpayer or filing jointly, and all persons whom the taxpayer expects to claim as a tax dependent. If the individual is under the age of 19 and living with a parent(s), move to Step C.  Is anyone in the household pregnant? If yes – the household also includes the total number of expected unborns.  STOP HERE. 2. If yes – continue to Step B.

B. Does the individual expect to be claimed as a tax dependent? i. If no – continue to Step C. ii. If yes – does the individual meet any of the following tax dependent exceptions?  The individual expects to be claimed as a tax dependent of someone other than a spouse or biological, adopted, or step parent.  The individual is a child under 19, living with both parents, but the parents do not expect to file a joint tax return.  The individual is a child under age 19, who expects to be claimed by a non-custodial parent. 1. If no – the household is the household of the taxpayer claiming him/her as a tax dependent.  Is the individual married? If yes – the household also includes the individual’s spouse.  Is anyone in the household pregnant? If yes – the household also includes the total number of expected unborns.  STOP HERE. 2. If yes – continue to Step C.

C. For individuals who neither expect to file a tax return nor expect to be claimed as a tax dependent, as well as tax dependents who meet one of the exceptions in B. ii., the household consists of the individual and, if living with the individual—  The individual’s spouse;  The individual’s biological, adopted, and step children under age 19;