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

 SAMUEL is not expected to file taxes and he is claimed as a tax dependent by his father Andrew. Samuel’s Medicaid eligibility will be determined under Nebraska’s standards for children age 1 through 5. If Samuel fails Medicaid eligibility, he may be eligible for CHIP because he is uninsured.  Samuel falls into one of the exceptions listed at 1-B-ii: he is living with both of his parents.  Because Samuel falls into one of the exceptions, we look to the rules for non- filers to determine Samuel’s household. This includes Samuel plus both his parents and his expected number of unborn siblings because they all live together.  SAMUEL’S MEDICAID/CHIP HOUSEHOLD = Samuel + Andrew + Elizabeth + 2 Unborns

2. DETERMINE THE MEDICAID/CHIP HOUSEHOLD INCOME FOR EACH HOUSEHOLD.

 DOUG’S MEDICAID HOUSEHOLD = Doug + Elizabeth + 2 Unborns  Doug is required to file taxes and is not the child or expected tax dependent of another member of his household. Elizabeth is the child and expected tax dependent of Doug.  Doug earns $2,000/month, so his MAGI-based income = $2,000/month. Doug’s household income = $2,000/month.  This household income equates to $2,000 for a household size of 4.  DOUG’S MEDICAID HOUSEHOLD INCOME = $2,000/month.

 ELIZABETH’S MEDICAID/CHIP HOUSEHOLD = Elizabeth + Doug + Andrew + 2 Unborns  Elizabeth is the expected tax dependent of Doug, but Elizabeth is not required to file a tax return.  Doug earns $2,000/month, so his MAGI-based income = $2,000/month.  Andrew earns $2,083/month, so his MAGI-based income = $2,083.  Elizabeth’s household income equals the sum of the MAGI of every member of her household. Elizabeth’s household income = $4,083/month.  This household income equates to 178% FPL* for a household size of 5.  ELIZABETH’S MEDICAID/CHIP HOUSEHOLD INCOME = 178% FPL.

 ANDREW’S MEDICAID HOUSEHOLD = Andrew + Elizabeth + Samuel + 2 Unborns

 Andrew is expected to file taxes and is not the child or expected tax dependent of another member of his household. Samuel is the child and expected tax dependent of Andrew, and when the twins are born, Andrew expects to claim them as tax dependents.  Andrew earns $2,083/month, so his MAGI-based income = $2,083/month