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

 In the case of individuals under age under age 19, the individual’s biological, adopted, and step parents and biological, adopted, and step siblings under age 19; and  In the case someone in the individual’s household is pregnant, the total number of expected unborns.

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

A. Is any household member the child or expected tax dependent of another member of the household? i. If yes – is the individual required to file a tax return?  If yes – continue to Step B and include the child’s income in the total household income.  If no – continue to Step B but do NOT include the child’s income in the total household income. ii. If no – continue to Step B.

B. Determine the MAGI-based income of each member of the individual’s household, unless the income of such member is flagged as not being counted in Step A. Recall that, for purposes of Medicaid and CHIP eligibility, the following rules apply, regardless of the rule applied for purposes of the Exchange/APTC eligibility:  An amount received as a lump sum is counted as income only for the month received.  Scholarships, awards, or fellowship grants used for education purposes and not for living expenses are excluded from income.  Certain distributions, payments, and student financial assistance for American Indians and Alaska Natives are excluded from income.  Actually available cash support, exceeding nominal amounts, provided by a person claiming an individual as a tax dependent but who is not the individual’s biological, adopted, or step parent is excluded from income.

C. Household income equals the sum of the MAGI of every member of the individual’s household determined in Step B.

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