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

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

 MARY’S MEDICAID HOUSEHOLD = Mary + Samantha + Joy

 Mary is required to file taxes and is not the child or expected tax dependent of another member of her household (A-ii). Therefore her Medicaid eligibility will be determined under Nebraska Parent/Caretaker Relative standards.  Samantha is the child and expected tax dependent of Mary, another member of the household (A-i). Samantha’s 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.  Joy is also the expected tax dependent of Mary (A-i). Joy’s 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.  Neither Samantha nor Joy are required to file a tax return (A-i), so we will continue to Step B, but we do NOT include the children’s incomes (Samantha - $300/month, Joy - $0) in the total household income.  Mary earns $4,500/month, so her MAGI-based income = $4,500/month (B).  The household’s income equals the sum of the MAGI of every member of Mary’s household (C), so Mary’s Medicaid household income = $4,500/month.  This household income equates to $4,500 for a household size of 3 for purposes of Parent/Caretaker Relative eligibility determination.  MARY’S MEDICAID HOUSEHOLD INCOME = $4,500/month.

 SAMANTHA’S MEDICAID/CHIP HOUSEHOLD = Samantha + Mary + Joy  Samantha’s Medicaid/CHIP household income determination is the same as Mary’s; however, because Samantha qualifies as a child, her income must be expressed in a percentage of FPL (see Step 3, below).  This household income equates to 277% FPL* for a household size of 3 for purposes of either a Medicaid eligibility determination for children age 6 through 18 or a CHIP eligibility determination.  SAMANTHA’S MEDICAID/CHIP HOUSEHOLD INCOME = 277% FPL.

 JOY’S MEDICAID/CHIP HOUSEHOLD = Joy + Samantha  Joy is the child of Samantha, another member of the household (A-i).  Joy is not required to file a tax return (A-i), so we will continue to Step B. Although Joy is claimed as a tax dependent by Mary, she meets the first exception (B-ii) and Joy’s household consists of Joy and Samantha (her parent).  Although Samantha is the child and expected tax dependent of Mary for purposes of determining Joy’s household, Samantha is NOT the child or expected tax dependent of another member of Joy’s household (= Joy + Samantha) (A-ii), so we will continue to Step B.