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

 STANLEY’S MEDICAID HOUSEHOLD = Stanley + Trent (Stanley’s son) + Jacob (Stanley and Kelly’s son)

 Stanley is required to file taxes and is not the child or expected tax dependent of another member of his household. Stanley’s Medicaid eligibility will be determined under Nebraska Parent/Caretaker Relative standards.  Trent is the child and expected tax dependent of Stanley.  Jacob is the child and expected tax dependent of Stanley.  Stanley earns $2,500/month, so his MAGI-based income = $2,500/month. Stanley’s Medicaid household income = $2,500/month  This household income equates to $2,500 for a household size of 3.  STANLEY’S MEDICAID HOUSEHOLD INCOME = $2,500/month.

 TRENT’S MEDICAID/CHIP HOUSEHOLD = Trent (Stanley’s son) + Stanley + Jacob (Stanley and Kelly’s son)  Trent’s Medicaid/CHIP household income determination is the same as his father Stanley’s. Trent’s Medicaid eligibility will be determined under Nebraska’s standards for children age 6 through 18 or, if necessary, CHIP.  Because Trent is a child, his income must be expressed in a percentage of FPL.  This household income equates to 154% FPL* for a household size of 3.  ISAAC’S MEDICAID/CHIP HOUSEHOLD INCOME = 154% FPL.

 JACOB’S MEDICAID/CHIP HOUSEHOLD = Jacob (Stanley and Kelly’s son) + Stanley + Trent (Stanley’s son)  Jacob’s Medicaid eligibility will be determined under Nebraska’s standards for children age 1 through 5 or, if necessary, CHIP.  Jacob’s Medicaid/CHIP household income determination is the sum of the MAGI of every member of his household.  Kelly earns $1,500/month and Stanley earns $2,500/month, so the monthly MAGI-based income = $4,000/month. Jacobs’s Medicaid/CHIP household income = $4,000/month  Because Jacob is a child, his income must be expressed in a percentage of FPL.  This household income equates to 174% FPL* for a household size of 5.  JACOB’S MEDICAID/CHIP HOUSEHOLD INCOME = 174% FPL.

3. DETERMINE WHETHER EACH INDIVIDUAL IS ELIGIBLE FOR MEDICAID/CHIP, OR WHETHER THEY ARE POTENTIALLY ELIGIBLE FOR THE EXCHANGE/APTC.