HOUSEHOLD COMPOSITION RELATED TO
MODIFIED ADJUSTED GROSS INCOME (MAGI) INCOME
For MAGI purposes, parents and children means all biological, adoptive or step relationships. Therefore,
step-parents will be included in the household with their spouse and stepchildren.
For all legally married couples who live together, each spouse is included in the household of the other
spouse. This is true whether they expect to file a tax return, file a joint tax return, or whether one
spouse expects to be claimed as a tax dependent by the other spouse.
If a tax filer cannot verify that an individual is their tax dependent, household composition for that
individual will be determined using the Non-Filer Rule.
Tax Filer Rules:
The following people are included in the household size if the tax filer is not also claimed as someone
else’s dependent:
Tax filer;
Tax filer’s spouse, if living with tax filer; and
Any individual reasonably established to be a tax dependent of the tax filer.
Tax Dependent Rules:
The following people are included in the household size of the tax dependent:
Tax dependent;
Tax filer that claimed the dependent;
Tax filer’s spouse, if living with the tax filer;
Tax dependent’s spouse, if living with the tax dependent; and
Any individual reasonably established to be a tax dependent of the tax filer.
Note:
The household size for an individual claiming to be a parent or caretaker may not include dependent
children. For example, an aunt claiming to be a caretaker relative and living with her niece or
nephew will be a single person household if she does not claim them as tax dependents. If a tax-filer
or applicant does not live with the dependent they are claiming, and have no dependent child in their
household, they are not a “caretaker relative” and are not eligible for Medicaid under the caretaker
relative category.
Household Example #1:
Lilly applies for Medicaid. She lives with her partner Bill and their common child, Bella, age 1.
Lilly and Bill are both employed and expect to file taxes. Since they are not married, they will file
separately. Bella is claimed as a dependent on Bill’s taxes.
Individual Explanations:
Lilly: As a tax filer, Lilly’s household is composed of herself only because Bella is Bill’s tax dependent (HH
size 1, income counted $1238/month)
Bill: As a tax filer, Bill’s household is composed of himself and Bella because she is his claimed tax
dependent (Household (HH) size 2, income counted $860/month)
Bella: Since Bella lives with both her natural parents, but they do not file jointly, she falls under the nonfiler rules. (HH size is 3 and BOTH parent’s income count, income counted $2098/month)
Household Example #2:
Aunt Betty lives with her own child, 6 year old Dan, and her nephew and niece, Jake, age 14 and Laurel,
age 17.
Jake and Laurel are being claimed as tax dependents on their mother’s taxes, but their mother lives in
another state.
Aunt Betty claims her child Dan as a dependent on her taxes.
Betty (income $1586/month) and Laurel (income $900/month) both work.
Laurel and Jake are siblings. Because Jake doesn’t live with his mother, we use non-filer rules to
determine his Medicaid eligibility.
Individual Explanations:
Aunt Betty: As a tax filer, with a dependent child, Betty’s household is composed of herself and Dan
(HH size 2, income counted $1586/month)
Dan: as a tax dependent of his mother, Dan’s household is himself and his mother, Betty (HH size 2,
income counted $1586/month)
Jake: Jake meets the rule for a dependent child NOT residing with the parent who claims him as a
dependent, so we use non-filer rules, and he and his child age sibling are counted in the same Medicaid
Household (HH size 2, income counted $900/month)
Laurel: Although Laurel is a tax filer, for Medicaid purposes she falls under the non-filer rules because
she doesn’t live with the parent that claims her as a dependent. Laurel’s household is composed of
herself and her brother Jake. (HH size 2, income counted $900/month)
Household Example #3:
Sophia (income $1000/month) lives with her 9 year old daughter, Monica. Monica is claimed as a
dependent by her non-custodial father, James, who lives in another city.
Individual Explanations:
Sophia: Is employed and is a tax filer, she is not claimed on another person’s taxes as a dependent, and
she doesn’t claim her daughter as a dependent. She lives with her 9 year old daughter, Monica. Sophia’s
household is composed of herself (HH size 1, income counted $1000/month)
Monica: Is a tax dependent of her father, with whom she doesn’t live, so she falls under the non-filer
rules since she meets the third exception under the non- filer rules (HH size 2, income counted is her
mother’s, $1000/month)
James: Although Monica is in his household size for tax purposes, James is ineligible for Medicaid for
himself since he doesn’t have a qualifying dependent child living with him.
Household Example #4:
April applies for Medicaid. She lives with her children, Deanna and Meg, twins, age 13. April’s only
income is Temporary Assistance for Needy Families (TANF); she doesn’t expect to have to file taxes
since TANF is not taxable income.
Individual Explanations:
April: Non-filer – we count all people related to her that live in her household (HH size 3, income of
TANF is $800/month)
Deanna: (HH size 3, income of TANF is $800/month)
Meg: (HH size 3, income of TANF is $800/month)
Household Example #5:
Luci, her husband, Joe, and their 2 children, Sam and Dean, apply for Medicaid. Joe receives Social
Security Disabiltiy (SSI), a small amount of Adult Public Assistance (APA) and works part time, Luci also
works part time and receives a small TANF benefit, but TANF is not taxable income.
They do file taxes jointly.
Individual Explanations:
Luci: Tax Filer – Luci’s household includes her husband and both children because she and Joe file
jointly. Only Joe’s earnings affect her eligibility. The SSI and APA income do not count. She works part
time earning $800 per month and receives TANF of $300 per month. (HH size 4, income is TANF
$300/month and earnings of $800 per month, Joe's earned income of $400/month)
Joe : Tax Filer – Joe is receiving SSI, APA and APA related Medicaid. He also works part time receiving
gross income of $400 per month. Joe’s earnings do affect the eligibility of the household, but he is not
being determined eligible for MAGI Medicaid because he is receiving APA related Medicaid. (HH size 1,
income is TANF $300/month, Luci's earnings of $800/month, and Joe's earned income of
$400/month)
Dean: (HH size 4, TANF is $300/month, Luci's earned income of $800/month, and Joe's earned income
of $400/month)
Sam: (HH size 4, TANF is $300/month, Luci's earned income of $800/month, and Joe's earned income of
$400/month)
Household Example #6:
Paul has a 7 year old child with Shauna, to whom he was never married. Their child’s name is Liza. For
the sake of Liza, Paul and Shauna live under the same roof, but Shauna later married Matt. Shauna also
has another child from a previous marriage.
Paul is the father to Liza, and claims Liza on his taxes as his dependent.
Shauna is the mother to both Liza and 17 year old Natalie. Shauna is the spouse of Matt, making Matt a
step-father to both children. Shauna files taxes jointly with her spouse.
Matt is the step-father to two children and spouse to Shauna, but has no children of his own. His
income counts to his spouse and to his step children. Matt and Shauna claim Natalie as a dependent on
their taxes.
Individual Explanations:
Paul: As a tax filer with a tax dependent child, Paul’s household is composed of himself and his daughter
Liza. (HH size 2, income counted $1586/month)
Liza: Is a “non-filer” because she is related to Paul and Shauna by birth, lives with both of them, but
they do not file jointly, Liza’s household is composed of herself and all other household members
including her step-father, Matt, since Matt and Shauna are married. (HH size 5, income counted
$3872/month)
Shauna: Since she files jointly with her spouse, Matt, and is the mother of both children in the
household, Shauna’s household is composed of herself, her spouse Matt, and her daughter, Natalie, but
not Liza since Liza is claimed by Paul. (HH size is 3, income counted $2286/month)
Matt: Shauna’s spouse, and step-father to both children in the household, Matt’s household is
composed of himself, his spouse Shauna, and Shauna’s daughter Natalie, but not Liza since Liza is
claimed by Paul. (HH size is 3, income counted $2286/month)
Natalie: Natalie is Shauna’s daughter and Matt’s step-daughter. (HH size is 3, income counted
$2286/month)
1/8/2014