Page 12

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

 Tax filing threshold: Tax dependents with more than $6,300* per year of earned income must file taxes.  Nebraska’s Medicaid income standard for children ages 6 through 18 is 133% FPL  Nebraska’s Medicaid income standard for children ages 1 through 5 is 145% FPL  Nebraska’s CHIP income standard is 213% FPL  Nebraska’s Parent/Caretaker Relative income maximum is:

* Federal Poverty Levels and federal tax filing thresholds are subject to change yearly.

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

 KELLY expects to file taxes and she does not expect to be claimed as a tax dependent, therefore her Medicaid eligibility will be determined under Nebraska Parent/Caretaker Relative standards. Kelly’s household consists of the taxpayer and all persons who the taxpayer expects to claim as a tax dependent. Kelly and Stanley are not married, so Stanley is NOT included in Kelly’s household.

 KELLY’S MEDICAID HOUSEHOLD = Kelly + Isaac (Kelly’s son)

 ISAAC (Kelly’s son) is not expected to file taxes and he is claimed as a tax dependent by his mother Kelly. Isaac’s Medicaid eligibility will be determined under Nebraska’s standards for children age 6 through 18. If Isaac fails Medicaid eligibility, he may be eligible for CHIP because he is uninsured.  None of the exceptions for tax dependents listed at 1-B-ii apply to Isaac.  Isaac’s household is the same as Kelly’s, the taxpayer claiming him as a dependent.  ISAAC’S MEDICAID/CHIP HOUSEHOLD = Isaac (Kelly’s son) + Kelly

 STANLEY expects to file taxes and he does not expect to be claimed as a tax dependent, therefore his Medicaid eligibility will be determined under Nebraska Parent/Caretaker Relative standards. Stanley’s household consists of the taxpayer and all persons who the taxpayer expects to claim as a tax dependent. Stanley and Kelly are not married, so Kelly is NOT included in Stanley’s household.  STANLEY’S MEDICAID HOUSEHOLD = Stanley + Trent (Stanley’s son) + Jacob (Stanley and Kelly’s son)

By household size/month: 1 - $569 2 - $704 3 - $841 4 - $976 5 - $1,112 6 - $1,247 7 - $1,383 Add- on for each additional family member - $133