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Families and Children Manual Policy Manual Number: 010.015 Section: Financial Eligibility Chapter: Eligibility Determination Group for MAGI

May 1, 2026 Division of TennCare 2 Tax Filer: An individual who expects to file a tax return for the taxable year in which an eligibility determination is made. A tax filer does not expect to be claimed as a tax dependent by another person. Tax Household: Tax filer (includes married couples filing jointly living in the same household) and all claimed dependents. Tax Filing Threshold: An annual income amount set by the Internal Revenue Service (IRS) that determines whether an individual is required to file income taxes. The threshold varies by age, marital status and the number of tax dependents claimed. Non-Filer: An individual who does not expect to file a tax return or be claimed as a tax dependent for the taxable year in which an eligibility determination is made. 3. Eligibility Determination Group There are 2 sets of EDG rules under MAGI methodology. Tax filer rules are for applicants who file taxes or are claimed as tax dependents. Non-filer rules are for those applicants that do not file taxes, are not claimed as tax dependent, or meet a tax dependent exception. NOTE: EDG is determined on an individual basis from the perspective of each individual. It is possible for household members to have different EDG sizes when determining eligibility. It is also worth noting that for individuals included in the EDG of his natural, adopted or stepparents that do not meet the tax filing threshold should not have income included in EDG income whether or not the individual files a tax return. 4. Tax Filers a. General Rule For applicants who expect to file taxes, the EDG includes the tax filer and any dependents the tax filer expects to claim. b. Tax Dependents For applicants claimed as tax dependents, the EDG is the same as the tax filer claiming the tax dependent. Tax dependents may include individuals not otherwise eligible for TennCare Medicaid or CoverKids, and who are not applying for benefits. If a non-custodial parent claims a child as a dependent, the dependent child will be included in the non-custodial parent’s EDG. c. Spouses Spouses who file joint taxes are both considered tax filers. For married couples who live together, each spouse will always be included in the other spouse’s EDG, regardless of the couple’s tax filing status. Spouses who expect to file joint taxes but live separately will not be included in each other’s EDG. The income of the spouse living outside of the household will be excluded from the EDG regardless of whether they file jointly or not.