Clarifying Information
(2)(b)(ii)(B) Clarified: A child being claimed as a tax dependent by a custodial parent who is living with both parents who are not married to each other would fall under this exception. (2)(b)(ii)(B) Clarified: The tax dependent expecting to be claimed by a noncustodial parent only applies to a child under age 19. Adult children over age 18 are not included in this exception. Household Defined: Medicaid households are based on a person’s family and tax relationships, as well as living arrangements. MAU Defined: MAU stands for “Medicaid assistance unit.” It refers to the individuals who are counted together when determining Medicaid eligibility. Each individual has his or her own MAU. This means different members of a household might all have different MAUs. Parent, child, and sibling relationships include biological, adopted, and step.
The Importance of MAU:
Knowing an individual’s MAU allows us to determine two key facts:
- The appropriate FPL standard; and
- Whose income to count when determining if the MAU's combined countable income is under the appropriate FPL standard.
Noncustodial and Custodial Parent:
The term noncustodial and custodial parent(s) only applies to a child under age 19. If there is no court order or binding agreement establishing physical custody controls, the custodial parent is the parent with whom the child spends the most nights.
College Students:
College students, including those age 19 or older, are treated as any other tax filer, tax dependent, or nonfiler according to the rules under WAC 182-506-0010. If they are a tax dependent, they should list themselves in Healthplanfinder as “tax dependent of someone on the application.” Healthplanfinder will prompt the tax dependent (college student) to enter the information for the tax filer(s) and other dependents.
Tax Filing Status:
Tax filing status should be entered as it is or is expected to be for the corresponding year of eligibility.
For example, if a married couple separates but still plans to file Married Filing Jointly for the current year, they would enter their tax filing status as Married Filing Jointly and indicate that their spouse is not living in the home. If their tax filing status is expected to be different for the following year, they would enter their expected tax filing status for the corresponding year.
Examples: Example 1: Jason applies for himself, his wife, Ashley, and their two children, 8 year old Paul and 6 year old Emma. Jason and Ashley plan to file a joint return claiming both their children as dependents.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size |
---|
Jason |
Tax Filer |
Jason, Ashley, and their tax dependents, Paul and Emma |
4 |
---|
Ashley |
Tax Filer |
Ashley, Jason, and their tax dependents, Paul and Emma |
4 |
---|
Paul |
Tax Dependent |
Paul, the tax payers, Jason and Emma, and their other tax dependent, Emma |
4 |
---|
Emma |
Tax Dependent |
Emma, the tax payers, Jason and Ashley, and their other tax dependent, Paul |
4 |
---|
Results: Jason and Ashley are tax filers, so Tax Filer rules apply to them. Paul and Emma are tax dependents for whom none of the exemptions listed under tax dependents apply, so tax dependent rules apply to them. The result is that for all four individuals, the MAU includes the tax payers and their two dependents.
Example 2: The scenario is the same as in Example 1, except that neither Jason nor Ashley expects to file taxes.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size |
---|
Jason |
Nonfiler |
Jason, his spouse, Ashley, and their children, Paul and Emma |
4 |
---|
Ashley |
Nonfiler |
Ashley, her spouse, Jason, and their children, Paul and Emma |
4 |
---|
Paul |
Nonfiler |
Paul, his parents Jason and Ashley, and his sibling Emma |
4 |
---|
Emma |
Nonfiler |
Emma, her parents, Jason and Ashley, and her sibling, Paul |
4 |
---|
Results: Since no one in the example is a tax filer or dependent, nonfiler rules apply. Spouses, parents and siblings for children under age 19 are considered for each individual. In examples 1 and 2, the same four family members are in each individual's MAU regardless of whether tax filer or nonfiler rules are used.
Example 3: Carol, age 60, applies for herself and her grandson, Cody, age 12. She states that she will file taxes and claim her grandson as a dependent.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size |
---|
Carol |
Tax Filer |
Carol and her dependent, Cody |
2 |
---|
Cody |
Nonfiler |
Cody |
1 |
---|
Results: Since Carol is a tax filer, her MAU includes herself and her grandson who is her tax dependent. Cody is a tax dependent who is claimed by a person who is not his parent or spouse (tax dependent, exception 1), therefore nonfiler rules apply for him and he has an MAU of one.
Example 4: Nick, age 30, lives with his son Alex, age 8, his girlfriend Shari, age 31, and their daughter in common, Joan, 1 year. Nick applies for himself and Alex. Nick does not expect to file taxes or be claimed as a tax dependent. Shari applies for herself and Joan. Shari is a tax filer and plans to claim Joan and Alex as her dependents.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size: |
---|
Nick |
Nonfiler |
Nick and his children, Alex and Joan |
3 |
---|
Alex |
Nonfiler |
Alex, his father Nick, and sibling Joan |
3 |
---|
Shari |
Tax-Filer |
Shari and her dependents, Alex and Joan |
3 |
---|
Joan |
Nonfiler |
Joan, her parents Nick and Shari, and sibling Alex |
4 |
---|
Results: Since Nick is a nonfiler, use nonfiler rules. His MAU includes himself and his 2 children. Alex is a tax dependent who is claimed by Shari. Since Shari is not his parent (tax dependent, exception 1), nonfiler rules apply for Alex. His MAU includes himself, his father, and his sibling. Shari is a tax payer, so her MAU includes herself and her 2 dependents. Joan is a tax dependent who is claimed by one parent, but lives with both parents who are not married so they do not file a joint tax return (tax dependent, exception 2). Nonfiler rules apply for Joan, so her MAU includes herself, both parents and her sibling.
Example 5: Sarah, age 19, applies for herself and her younger brother John, age 9. She states that she is a tax filer and will claim John as a dependent. Sara is pregnant and is expecting twins.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size: |
---|
Sarah |
Tax Filer |
Sarah + 2 unborn, and John |
4 |
---|
John |
Nonfiler |
John |
1 |
---|
Results: Since Sara is a tax filer, her MAU includes herself, her brother who is her tax dependent, and her 2 unborn. John is a tax dependent who is claimed by a person who is not his parent or spouse (tax dependent, exception 1), therefore nonfiler rules apply to him and he has an MAU of one.
Example 6: Jim and Jill, both age 30 are divorced with a child in common, Kyle, age 6, who lives with Jill but is claimed as a tax dependent by Jim. Jill is a tax filer and applies for herself and Kyle. Jim, who lives in a different town, applies separately for himself.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size: |
---|
Jim |
Tax Filer |
Jim and his tax dependent, Kyle |
2 |
---|
Jill |
Tax Filer |
Jill |
1 |
---|
Kyle |
Nonfiler |
Kyle and his mother, Jill |
2 |
---|
Results: Even though Kyle does not live with Jim he would still be included in Jim’s MAU since he is claimed as a tax dependent. Jill is also a tax filer and she would include herself but not her son as he is being claimed by Jim who lives outside the home. Kyle is a tax dependent who is claimed by a noncustodial parent (tax dependent, exception 3) so nonfiler rules apply to him. Under nonfiler rules, an individual under age 19 includes his parent(s) in his MAU if living with them.
Example 7: The scenario is the same as Example 6 except Jill does not file a tax return.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size: |
---|
Jim |
Tax Filer |
Jim and his tax dependent, Kyle |
2 |
---|
Jill |
Nonfiler |
Jill and Kyle |
2 |
---|
Kyle |
Nonfiler |
Kyle and his mother, Jill |
2 |
---|
Results: Even though Kyle does not live with Jim he would still be included in Jim’s MAU since he is claimed as a tax dependent. Since Jill is a nonfiler and is not claimed by another person nonfiler rules apply. She has an MAU of 2, her and her son, Kyle. Kyle is a tax dependent who is claimed by a noncustodial parent (tax dependent, exception 3) so nonfiler rules apply to him.
Example 8: Natalia, age 45, lives with her daughter, Catalina, age 18 and her granddaughter Mia, age 1. Natalia files taxes and claims both her daughter, Catalina and granddaughter, Mia. Natalia applies for herself and her daughter Catalina. Catalina applies separately for her daughter, Mia.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler rule: |
Who to include: |
MAU size |
---|
Natalia |
Tax Filer |
Natalia, and her tax dependents Catalina and Mia |
3 |
---|
Catalina |
Tax Dependent |
Catalina, her mother Natalia, and her daughter, Mia |
3 |
---|
Mia |
Nonfiler |
Mia and her mother, Catalina |
2 |
---|
Results: Since Natalia is a tax filer, use tax filer rules. Her MAU includes herself and her two tax dependents, Catalina and Mia. Catalina is a tax dependent and she doesn’t meet any of the exceptions so her MAU is exactly like the tax filer claiming her: Catalina, Natalia, and Mia. Mia is a tax dependent claimed by Natalia. Since Natalia is not her parent (tax dependent, exception 1), nonfiler rules apply for Mia. Her MAU included her mother and herself.
Example 9: Carlos applies for himself, his spouse, Sebastian, and their 17 year old niece, Ana. Carlos and Sebastian file a joint tax return and claim their 20 year old son, Rafael, who is away at college, and Ana. Rafael applies separately.
Determine MAU for: |
Tax filer, tax dependent, or nonfiler: |
Who to include: |
MAU size: |
---|
Carlos |
Tax Filer |
Carlos, Sebastian, Rafael, and Ana |
4 |
---|
Sebastian |
Tax Filer |
Sebastian, Carlos, Rafael, and Ana |
4 |
---|
Rafael |
Tax Dependent: Must apply for Medicaid on his own since he is age 20 |
Rafael, Carlos, Sebastian, and Ana |
4 |
---|
Ana |
Nonfiler |
Ana |
1 |
---|
Results: Carlos and Sebastian are tax filers claiming Rafael and Ana as tax dependents so their MAUs would include themselves, their spouse and both tax dependents. Rafael is away at college and his parents expect to claim him. He is a tax dependent and doesn’t meet any of the exceptions so his MAU is the same as the tax filer claiming him: Rafael, his parents, and his cousin, Ana. Nonfiler rules apply to Ana since she is being claimed by someone other than a spouse or parent (exception 1). Her MAU would only include herself.