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 (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) [not filing return or claimed as a dependent] of this section.  Copied from  42 CFR 435.603 – Application of modified adjusted gross income (MAGI)

Scroll down to see flow chart on Household Size

Household Size for Medi Cal qualification

Check out the Household Size Flow chart  below, or click on it to get a sharper image,  for a simpler way of looking at the 42 CFR 435.603 rules.

2 comments on “Married Couples Household definition f 4

  1. If we are married but I live in CA with my kids (from past relationship) and he is in another state living for the next year, does he count as part of our household?

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