us/regulation/42/435/603/f

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us/regulation/42/435/603/f · Axiom

(2)#

(2) Basic rule for individuals claimed as a tax dependent. In the case of an individual who expects to be claimed as a tax dependent by another taxpayer for the taxable year in which an initial determination or renewal of eligibility is being made, the household is the household of the taxpayer claiming such individual as a tax dependent, except that the household must be determined in accordance with paragraph (f)(3) of this section in the case of—

(i) Individuals other than a spouse or child who expect to be claimed as a tax dependent by another taxpayer; and

(ii) Individuals under the age specified by the State under paragraph (f)(3)(iv) of this section who expect to be claimed by one parent as a tax dependent and are living with both parents but whose parents do not expect to file a joint tax return; and

(iii) Individuals under the age specified by the State under paragraph (f)(3)(iv) of this section who expect to be claimed as a tax dependent by a non-custodial parent. For purposes of this section—

(A) A court order or binding separation, divorce, or custody agreement establishing physical custody controls; or

(B) If there is no such order or agreement or in the event of a shared custody agreement, the custodial parent is the parent with whom the child spends most nights.

(3) Rules for individuals who neither file a tax return nor are claimed as a tax dependent. In the case of individuals who do not expect to file a Federal tax return and do not expect to be claimed as a tax dependent for the taxable year in which an initial determination or renewal of eligibility is being made, or who are described in paragraph (f)(2)(i), (f)(2)(ii), or (f)(2)(iii) of this section, the household consists of the individual and, if living with the individual—

(i) The individual's spouse;

(ii) The individual's children under the age specified in paragraph (f)(3)(iv) of this section; and

(iii) In the case of individuals under the age specified in paragraph (f)(3)(iv) of this section, the individual's parents and siblings under the age specified in paragraph (f)(3)(iv) of this section.

(iv) The age specified in this paragraph is either of the following, as elected by the agency in the State plan—

(A) Age 19; or

(B) Age 19 or, in the case of full-time students, age 21.

(4) Married couples. In the case of a married couple living together, each spouse will be included in the household of the other spouse, regardless of whether they expect to file a joint tax return under section 6013 of the Code or whether one spouse expects to be claimed as a tax dependent by the other spouse.

(5) For purposes of paragraph (f)(1) of this section, if, consistent with the procedures adopted by the State in accordance with § 435.956(f) of this part, a taxpayer cannot reasonably establish that another individual is a tax dependent of the taxpayer for the tax year in which Medicaid is sought, the inclusion of such individual in the household of the taxpayer is determined in accordance with paragraph (f)(3) of this section.

(2)(i)#

(i) Individuals other than a spouse or child who expect to be claimed as a tax dependent by another taxpayer; and

(2)(ii)#

(2)(iii)#

(A) A court order or binding separation, divorce, or custody agreement establishing physical custody controls; or

(B) If there is no such order or agreement or in the event of a shared custody agreement, the custodial parent is the parent with whom the child spends most nights.

(i) The individual's spouse;

(ii) The individual's children under the age specified in paragraph (f)(3)(iv) of this section; and

(iv) The age specified in this paragraph is either of the following, as elected by the agency in the State plan—

(A) Age 19; or

(B) Age 19 or, in the case of full-time students, age 21.

(2)(iii)(A)#

(A) A court order or binding separation, divorce, or custody agreement establishing physical custody controls; or

(2)(iii)(B)#

(B) If there is no such order or agreement or in the event of a shared custody agreement, the custodial parent is the parent with whom the child spends most nights.

(i) The individual's spouse;

(ii) The individual's children under the age specified in paragraph (f)(3)(iv) of this section; and

(iv) The age specified in this paragraph is either of the following, as elected by the agency in the State plan—

(A) Age 19; or

(B) Age 19 or, in the case of full-time students, age 21.

(2)(iii)(B)(3)#

(i) The individual's spouse;

(ii) The individual's children under the age specified in paragraph (f)(3)(iv) of this section; and

(iv) The age specified in this paragraph is either of the following, as elected by the agency in the State plan—

(A) Age 19; or

(B) Age 19 or, in the case of full-time students, age 21.

(2)(iii)(B)(3)(i)#

(i) The individual's spouse;

(2)(iii)(B)(3)(ii)#

(ii) The individual's children under the age specified in paragraph (f)(3)(iv) of this section; and

(2)(iii)(B)(3)(iii)#

(2)(iii)(B)(3)(iv)#

(iv) The age specified in this paragraph is either of the following, as elected by the agency in the State plan—

(A) Age 19; or

(B) Age 19 or, in the case of full-time students, age 21.

(2)(iii)(B)(3)(iv)(A)#

(A) Age 19; or

(2)(iii)(B)(3)(iv)(B)#

(B) Age 19 or, in the case of full-time students, age 21.

(2)(iii)(B)(3)(iv)(B)(4)#

(2)(iii)(B)(3)(iv)(B)(5)#

in view

Whole section

Encodings · 10

state_plan_child_age_threshold42 CFR § 435.603 (f) · parameter

42 CFR 435.603(f)(3)(iv)(A)

name: state_plan_child_age_threshold
kind: parameter
dtype: Count
source: 42 CFR 435.603(f)(3)(iv)(A)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/603/f
          excerpt: Age 19
versions:
  - effective_from: '0001-01-01'
    formula: '19'

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state_plan_full_time_student_age_threshold42 CFR § 435.603 (f) · parameter

42 CFR 435.603(f)(3)(iv)(B)

name: state_plan_full_time_student_age_threshold
kind: parameter
dtype: Count
source: 42 CFR 435.603(f)(3)(iv)(B)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/regulation/42/435/603/f
          excerpt: in the case of full-time students, age 21
versions:
  - effective_from: '0001-01-01'
    formula: '21'

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under_state_plan_age42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(3)(iv)

name: under_state_plan_age
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(3)(iv)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: >-
      person_age < state_plan_child_age_threshold

      or (state_plan_elects_full_time_student_age_21 and
      person_is_full_time_student and person_age <
      state_plan_full_time_student_age_threshold)

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tax_dependent_exception_uses_non_filer_household_rules42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(2)(i)-(iii)

name: tax_dependent_exception_uses_non_filer_household_rules
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(2)(i)-(iii)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: >-
      tax_dependent_is_not_spouse_or_child_of_claiming_taxpayer

      or (under_state_plan_age and
      expected_to_be_claimed_by_one_parent_and_living_with_both_parents_and_parents_do_not_expect_joint_return)

      or (under_state_plan_age and
      expected_to_be_claimed_by_non_custodial_parent)

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non_filer_household_rules_apply42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(3)

name: non_filer_household_rules_apply
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(3)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: >-
      (not expects_to_file_federal_tax_return and not
      expects_to_be_claimed_as_tax_dependent)

      or tax_dependent_exception_uses_non_filer_household_rules

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basic_taxpayer_household_member42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(1), (f)(5)

name: basic_taxpayer_household_member
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(1), (f)(5)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: definition
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: >-
      individual_expects_to_file_tax_return

      and not
      individual_expects_to_be_claimed_as_tax_dependent_by_another_taxpayer

      and (candidate_is_the_individual or
      (individual_expects_to_claim_candidate_as_tax_dependent and
      taxpayer_can_reasonably_establish_candidate_as_tax_dependent))

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claimed_tax_dependent_household_member42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(2)

name: claimed_tax_dependent_household_member
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: definition
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: |-
      individual_expects_to_be_claimed_as_tax_dependent_by_another_taxpayer
      and not tax_dependent_exception_uses_non_filer_household_rules
      and candidate_is_in_household_of_taxpayer_claiming_individual

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non_filer_household_member42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(3)

name: non_filer_household_member
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(3)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: definition
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: >-
      non_filer_household_rules_apply

      and (candidate_is_the_individual

      or (candidate_lives_with_individual and candidate_is_individuals_spouse)

      or (candidate_lives_with_individual and candidate_is_individuals_child and
      candidate_under_state_plan_age)

      or (individual_under_state_plan_age and candidate_lives_with_individual
      and candidate_is_individuals_parent)

      or (individual_under_state_plan_age and candidate_lives_with_individual
      and candidate_is_individuals_sibling and candidate_under_state_plan_age))

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spouse_included_in_household42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(4)

name: spouse_included_in_household
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(4)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: definition
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: candidate_is_individuals_spouse and candidate_lives_with_individual

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medicaid_household_member42 CFR § 435.603 (f) · derived

42 CFR 435.603(f)(1)-(5)

name: medicaid_household_member
kind: derived
entity: Person
dtype: Judgment
period: Year
source: 42 CFR 435.603(f)(1)-(5)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/603/f
versions:
  - effective_from: '0001-01-01'
    formula: |-
      basic_taxpayer_household_member
      or claimed_tax_dependent_household_member
      or non_filer_household_member
      or spouse_included_in_household

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▸rulespec code

Shown source

regulations/42-cfr/435/603/f.yaml

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Rules

state_plan_child_age_threshold

Parameter

source: 42 CFR 435.603(f)(3)(iv)(A)

- name: state_plan_child_age_threshold
  kind: parameter
  dtype: Count
  source: 42 CFR 435.603(f)(3)(iv)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/603/f
            excerpt: Age 19
  versions:
    - effective_from: '0001-01-01'
      formula: '19'

state_plan_full_time_student_age_threshold

Parameter

source: 42 CFR 435.603(f)(3)(iv)(B)

- name: state_plan_full_time_student_age_threshold
  kind: parameter
  dtype: Count
  source: 42 CFR 435.603(f)(3)(iv)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/regulation/42/435/603/f
            excerpt: in the case of full-time students, age 21
  versions:
    - effective_from: '0001-01-01'
      formula: '21'

under_state_plan_age

Derived

source: 42 CFR 435.603(f)(3)(iv)

- name: under_state_plan_age
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(3)(iv)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: >-
        person_age < state_plan_child_age_threshold

        or (state_plan_elects_full_time_student_age_21 and person_is_full_time_student and
        person_age < state_plan_full_time_student_age_threshold)

tax_dependent_exception_uses_non_filer_household_rules

Derived

source: 42 CFR 435.603(f)(2)(i)-(iii)

- name: tax_dependent_exception_uses_non_filer_household_rules
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(2)(i)-(iii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: >-
        tax_dependent_is_not_spouse_or_child_of_claiming_taxpayer

        or (under_state_plan_age and
        expected_to_be_claimed_by_one_parent_and_living_with_both_parents_and_parents_do_not_expect_joint_return)

        or (under_state_plan_age and expected_to_be_claimed_by_non_custodial_parent)

non_filer_household_rules_apply

Derived

source: 42 CFR 435.603(f)(3)

- name: non_filer_household_rules_apply
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: |-
        (not expects_to_file_federal_tax_return and not expects_to_be_claimed_as_tax_dependent)
        or tax_dependent_exception_uses_non_filer_household_rules

basic_taxpayer_household_member

Derived

source: 42 CFR 435.603(f)(1), (f)(5)

- name: basic_taxpayer_household_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(1), (f)(5)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: >-
        individual_expects_to_file_tax_return

        and not individual_expects_to_be_claimed_as_tax_dependent_by_another_taxpayer

        and (candidate_is_the_individual or (individual_expects_to_claim_candidate_as_tax_dependent
        and taxpayer_can_reasonably_establish_candidate_as_tax_dependent))

claimed_tax_dependent_household_member

Derived

source: 42 CFR 435.603(f)(2)

- name: claimed_tax_dependent_household_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: |-
        individual_expects_to_be_claimed_as_tax_dependent_by_another_taxpayer
        and not tax_dependent_exception_uses_non_filer_household_rules
        and candidate_is_in_household_of_taxpayer_claiming_individual

non_filer_household_member

Derived

source: 42 CFR 435.603(f)(3)

- name: non_filer_household_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: >-
        non_filer_household_rules_apply

        and (candidate_is_the_individual

        or (candidate_lives_with_individual and candidate_is_individuals_spouse)

        or (candidate_lives_with_individual and candidate_is_individuals_child and
        candidate_under_state_plan_age)

        or (individual_under_state_plan_age and candidate_lives_with_individual and
        candidate_is_individuals_parent)

        or (individual_under_state_plan_age and candidate_lives_with_individual and
        candidate_is_individuals_sibling and candidate_under_state_plan_age))

spouse_included_in_household

Derived

source: 42 CFR 435.603(f)(4)

- name: spouse_included_in_household
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(4)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: candidate_is_individuals_spouse and candidate_lives_with_individual

medicaid_household_member

Derived

source: 42 CFR 435.603(f)(1)-(5)

- name: medicaid_household_member
  kind: derived
  entity: Person
  dtype: Judgment
  period: Year
  source: 42 CFR 435.603(f)(1)-(5)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/603/f
  versions:
    - effective_from: '0001-01-01'
      formula: |-
        basic_taxpayer_household_member
        or claimed_tax_dependent_household_member
        or non_filer_household_member
        or spouse_included_in_household

▸citations (1)

References

This rule cites 1 other rule.

42 CFR § 435.956 (f)inferredUS Federal › Regulations › Title 42 › § 435 › (956)(f)

(1)#

(2)#

(2)(i)#

(2)(ii)#

(2)(iii)#

(2)(iii)(A)#

(2)(iii)(B)#

(2)(iii)(B)(3)#

(2)(iii)(B)(3)(i)#

(2)(iii)(B)(3)(ii)#

(2)(iii)(B)(3)(iii)#

(2)(iii)(B)(3)(iv)#

(2)(iii)(B)(3)(iv)(A)#

(2)(iii)(B)(3)(iv)(B)#

(2)(iii)(B)(3)(iv)(B)(4)#

(2)(iii)(B)(3)(iv)(B)(5)#