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

1. CONSTRUCT A MEDICAID/CHIP HOUSEHOLD FOR EACH APPLICANT.

 BOB expects to file taxes and he does not expect to be claimed as a tax dependent, therefore his Medicaid eligibility will be determined under Nebraska Parent/Caretaker Relative standards. Bob’s household consists of the taxpayer and all persons who the taxpayer expects to claim as a tax dependent.  BOB’S MEDICAID HOUSEHOLD = Bob + Sophia

 SOPHIA is not expected to file taxes and she is claimed as a tax dependent by her father, Bob. Sophia’s Medicaid eligibility will be determined under Nebraska’s standards for children age 6 through 18. If Sophia fails Medicaid eligibility, she may be eligible for CHIP because she is uninsured.  None of the exceptions for tax dependents listed at 1-B-ii apply to Sophia.  Because Sophia is not married, and no one in the household is pregnant, Sophia's household is the same as the household of Bob, the taxpayer claiming her as a dependent.  SOPHIA’S MEDICAID/CHIP HOUSEHOLD = Sophia + Bob

 EMMA is not expected to file taxes and she is claimed as a tax dependent by her father Harold. Emma’s Medicaid eligibility will be determined under Nebraska’s standards for children age 1 through 5. If Emma fails Medicaid eligibility, she may be eligible for CHIP because she is uninsured.  One of the exceptions for tax dependents listed at 1-B-ii applies to Emma: she is a child who expects to be claimed by a non-custodial parent.  Because Emma falls into one of the exceptions, we look to the rules for non-filers to determine Emma’s household. This includes Emma plus her mother, Sophia, because Sophia and Emma live together.  EMMA’S MEDICAID/CHIP HOUSEHOLD = Emma + Sophia

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

 BOB’S MEDICAID HOUSEHOLD = Bob + Sophia

 Bob is required to file taxes and is not the child or expected tax dependent of another member of his household. Bob’s Medicaid eligibility will be determined under Nebraska Parent/Caretaker Relative standards.  Sophia is the child and expected tax dependent of Bob, so her Medicaid eligibility will be determined under Nebraska’s standards for children age 6 through 18 or, if necessary, CHIP.  Sophia is not required to file a tax return, so we will NOT include Sophia’s income ($300/month) in the total household income.  Bob earns $4,500/month, so his MAGI-based income = $4,500/month. Because Sophia’s income does not count, Bob’s Medicaid household income = $4,500/month.  The household’s income equals the sum of the MAGI of every member of Bob’s household, so Bob’s Medicaid household income = $4,500/month.