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

 This household income equates to $4,500 for a household size of 2.  BOB’S MEDICAID HOUSEHOLD INCOME = $4,500/month.

 SOPHIA’S MEDICAID/CHIP HOUSEHOLD = Sophia + Bob  Sophia’s Medicaid/CHIP household income determination is the same as her father Bob’s; however, because Sophia qualifies as a child, her income must be expressed in a percentage of FPL.  This household income equates to 348% FPL* for a household size of 2.  SOPHIA’S MEDICAID/CHIP HOUSEHOLD INCOME = 348% FPL.

 EMMA’S MEDICAID/CHIP HOUSEHOLD = Emma + Sophia  Emma is the child of Sophia, another member of the household, so Emma’s Medicaid eligibility will be determined under Nebraska’s standards for children age 1 through 5 or, if necessary, CHIP.  Emma is not required to file a tax return, so will NOT include Emma’s income ($0) in the total household income.  Although Sophia is the child and expected tax dependent of Bob for purposes of determining Bob’s household, Sophia is NOT the child or expected tax dependent of another member of Emma’s household (= Emma + Sophia).  Although Sophia is not required to file a tax return, her income counts because neither of her parents is included in this household.  Sophia earns $300/month, so her MAGI-based income = $300/month. Sophia’s Medicaid/CHIP household income = $300/month.  This household income equates to 23% FPL* for a household size of 2.  EMMA’S MEDICAID/CHIP HOUSEHOLD INCOME = 23% FPL.

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

 BOB:  Nebraska’s Parent/Caretaker Relative income maximum is*:

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