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

 This household income equates to $2,083 for a household size of 5.  ANDREW’S MEDICAID/CHIP HOUSEHOLD INCOME = $2,083/month.

Note: Although Elizabeth is a tax dependent of her father Doug, Doug is not included in Andrew’s household. Thus, if Elizabeth had any income, it would count, regardless of whether she had a filing requirement. This would also apply in Sam’s determination, below.

 SAMUEL’S MEDICAID/CHIP HOUSEHOLD = Samuel + Andrew + Elizabeth + 2 Unborns  Samuel’s Medicaid/CHIP household income determination is the same as Andrew’s; however, because Samuel is a child, his income must be expressed in a percentage of FPL.  This household income equates to 90% FPL* for a household size of 5.  SAMUEL’S MEDICAID/CHIP HOUSEHOLD INCOME = 90% FPL.

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

 DOUG:  Nebraska’s Parent/Caretaker Relative income maximum is:

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

 Doug’s Medicaid household income of $2,000/month for a household size of 4 exceeds the maximum of $976/month, so Doug is not eligible for Medicaid based on MAGI. But he may be eligible for premium tax credits and cost sharing reductions through the Marketplace.

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