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

 MARY’S MEDICAID HOUSEHOLD = Mary + Samantha + Joy Note: Because Mary is not a child she is ineligible for CHIP.

 SAMANTHA is not expected to file taxes (A-i) and she expects to be claimed as a tax dependent by her mother Mary (B-ii), so her Medicaid eligibility will be determined under Nebraska’s standards for children age 6 through 18. If Samantha fails Medicaid eligibility, she may be eligible for CHIP because she is uninsured.  We must consider whether any of the exceptions for tax dependents apply, as listed below:  Is the individual (Samantha) the tax dependent of someone other than a spouse or a biological, adopted, or step parent?  NO  Is the individual (Samantha) a child living with both parents, but the parents do not expect to file a joint tax return?  NO  Is the individual (Samantha) a child who expects to be claimed by a non-custodial parent?  NO  Because none of the tax dependent exceptions apply, Samantha is not married, and no one in the household is pregnant, Samantha’s household is the same as the household of Mary, the taxpayer claiming her as a dependent (B-ii-1).  SAMANTHA’S MEDICAID/CHIP HOUSEHOLD = Samantha + Mary + Joy

 JOY is not expected to file taxes (A-i) and she is claimed as a tax dependent by her grandmother Mary (B-ii), so her Medicaid eligibility will be determined under Nebraska’s standards for children age 1 through 5. If Joy fails Medicaid eligibility, she may be eligible for CHIP because she is uninsured.  We must consider whether any of the exceptions for tax dependents apply, as listed below:  Is the individual (Joy) the tax dependent of someone other than a spouse of a biological, adopted, or step parent?  YES (her grandmother, Mary)  Is the individual (Joy) a child living with both parents, but the parents do not expect to file a joint tax return?  NO  Is the individual (Joy) a child who expects to be claimed by a non- custodial parent?  NO  Because Joy falls into one of the exceptions, we look to the rules for non-filers (C) to determine Joy’s household. This includes Joy plus any of the following, if they live with her:  A spouse  NO  The children of the individual  NO  A parent or siblings of the individual  YES – mother (Samantha)  The total number of expected unborns if a member of the household is pregnant  NO  JOY’S MEDICAID/CHIP HOUSEHOLD = Joy + Samantha