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

 ELIZABETH:  Nebraska’s Medicaid income standard for children ages 6 to 18 is 133% FPL, and the CHIP standard is 213% FPL.  Nebraska’s Medicaid income standard for pregnant women is 194% FPL.  With a Medicaid/CHIP household income of 194% FPL, Elizabeth is not eligible for Medicaid as a child age 6 through 18. However, when a pregnant minor does not qualify for Medicaid under children’s standards, she may qualify under pregnant women’s standards.  With a Medicaid/CHIP household income of 194% FPL, Elizabeth is eligible for Medicaid as a pregnant woman. If Elizabeth had failed Medicaid eligibility under the pregnant women’s group, she may have been eligible for CHIP because she is uninsured.  ANDREW:  Nebraska’s Parent/Caretaker Relative income maximum is*:

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

 Andrew’s Medicaid household income $2,083/month for a household size of 5 exceeds the maximum of $1,112/month, so Andrew is not eligible for Medicaid based on MAGI. But he may be eligible for premium tax credits and cost sharing reductions through the Marketplace.

 SAMUEL:  Nebraska’s Medicaid income standard for children ages 1 to 5 is 145% FPL, and the CHIP standard is 213% FPL.  With a Medicaid/CHIP household of 90% FPL, Samuel is eligible for Medicaid. If Samuel had not been eligible for Medicaid, he may have been eligible for CHIP because he is uninsured and his FPL percentage is below the CHIP income standard. Joint Custody In situations where a child spends an equal number of nights with each parent, the income of each parent must be used to determine eligibility for the child.

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