817-1      CONSTRUCT A MAGIModified Adjusted Gross Income HOUSEHOLD FOR EACH INDIVIDUAL

MAGIModified Adjusted Gross Income Medicaid household composition for each individual is determined using tax filing rules.  

The household size of a pregnant woman also includes the unborn child or children expected. The unborn child does not count in the household size of the other members. The needs and income of the father of the unborn child are not included in this determination unless he is part of the tax filing household.

Usually the tax household consists of parents and their dependent children (biological, adopted, or step); however, IRSInternal Revenue Service rules allow that tax dependents can also be qualifying relatives and even non-relatives. Extended family members and unrelated individuals claimed as tax dependents can be in the same MAGIModified Adjusted Gross Income Medicaid household. Non-relative dependents may count for household size, but may not be covered by Medicaid unless they meet one of the available categories.

Please note, a "Dependent Child" is defined in MAGI MS 816-1(D).

Use the following chart to determine each individual's household composition. The individual's household composition will determine whose income in the household is included for the individual's MAGIModified Adjusted Gross Income Medicaid eligibility determination.

A.    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 the tax filer or filing jointly; and
• Any individual reasonably established to be a tax dependent of the tax filer.

B.    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 or filing jointly;
• Tax dependent’s spouse, if living with the tax dependent or filing jointly; and
• Any individual reasonably established to be a tax dependent of the tax filer.

C.    Non-Tax Filer Rules:

A household size is determined by the Non-Filer Rule if any of the following are true:

• Individual is claimed as a tax dependent by someone other than a parent/stepparent; or
• Individual is a child who lives with two parents and is claimed as a tax dependent by one parent, but the parents do not file jointly; or
• Individual is a child who lives with a parent/stepparent, but is claimed as a tax dependent by a non-custodial parent.

If an individual is a Non-Filer, the following household size is established:

• Individual;
• Individual’s spouse, if living with individual;
• Individual’s (natural, adopted, or step) children under age 19, if living with the individual;
• If the individual is under age 19, the Individual’s (natural, adopted, or step) parents, if living with the individual; and
• If the individual is under age 19, the individual's (natural, adopted, or step) siblings under the age of 19, if living with the individual.

Tax Filer Household Composition

Chart A

Tax Dependent Household Composition

Chart B

Non-Filer Household Composition

Chart C