How many people are in the Household?
What is the definition?

The sample redetermination form  MC 216 states:

We may need some information about people in your household who live with you or are listed on your tax return, who do not have Medi-Cal and who do not want to apply for Medi-Cal.Sample MC 216

Please note that, Medi-Cal wants to cover everyone and may go beyond the law to gather information to do that.  There are also many other programs that Medi-Cal has that you might qualify for and no one would know unless they asked.  Such as:

MORE Social Services – In Addition to Medi-Cal

IHSS In Home Supportive Services

(f) Household
Definition  (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.

Plain English FAQ

If an adult is claimed as a tax dependent by their parents, will their parents income count towards the dependent adult’s income for eligibility?

Yes. The adult who expects to be claimed as a tax dependent by his/her parents will have his parents income counted when determining income eligibility under the MAGI methodology.  Federal regulatory reference is 42 CFR 435.603(f)(2). dhcs.ca.gov  *

Check out the Household Size Flow chart  below for a simpler way of looking at the 42 CFR 435.603 rules.

Flow Chart
Flow Chart based on 42 CFR 435.603

(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.  Copied from  42 CFR 435.603 – Application of modified adjusted gross income (MAGI) 

For other scenarios – check out the related pages in  Household Definition – Who counts?  section
 .

Leave a Reply

Your email address will not be published.

wp-puzzle.com logo