Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-4 - Medicaid for the MAGI Covered Groups › Section 5160:1-4-01 - MAGI-based medicaid: household composition and income

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule d escribes household composition and income
			 calculations under
			 42 C.F.R.
			 435.603 (as in effect October 1, 2020) when
			 determining an individual's eligibility for modified adjusted gross income
			 (MAGI) based medical assistance. This rule does not apply to determinations for
			 categories of medical assistance on the basis of age, blindness, or disability,
			 or which only cover an individual's medicare premium or
			 cost-sharing.
(B)
								Definition. "Person" for the purpose of this rule,
			 means someone in the family or household of an individual applying for or
			 receiving medical assistance.
(C)
								Determining
			 household composition and family size.
(1)
									For the tax year
			 in which the eligibility determination is being made, household composition and
			 family size are determined for each individual as follows:
(a)
										If an individual
			 expects to file a federal income tax return and does not expect to be claimed
			 as a tax dependent, the household composition is the individual, the
			 individual's spouse if they live together, and all persons whom the individual
			 expects to claim as a tax dependent as determined under
			 42 C.F.R.
			 435.603(f)(1) (as in effect
			 October 1, 2020).
(b)
										If an individual expects to be claimed as a tax
			 dependent, the household composition is the taxpayer, the taxpayer's spouse if
			 they live together, the individual, and all other persons whom the taxpayer
			 expects to claim as a tax dependent as determined under
			 42 C.F.R.
			 435.603(f)(2) (as in effect
			 October 1, 2020), unless the individual meets one of the following
			 exceptions:
(i)
											The individual is a tax dependent of someone other than a
			 spouse or parent.
(ii)
											The individual is a child under the age of nineteen
			 living with both parents who do not expect to file taxes
			 jointly.
(iii)
											The individual is a child under the age of nineteen who
			 expects to be claimed as a tax dependent by a non-custodial
			 parent.
(c)
										If an individual does not expect to file a federal
			 income tax return or to be claimed as a tax dependent, or it is unclear if the
			 individual will be claimed as a tax dependent, the household composition is
			 determined under
			 42 C.F.R.
			 435.603(f)(3) (as in effect
			 October 1, 2020) as follows:
(i)
											If the non-filer is an adult, the household includes
			 the individual, the individual's spouse if living together, and the
			 individual's children under the age of nineteen.
(ii)
											If the non-filer
			 is a child under the age of nineteen, the household includes the individual,
			 the individual's parents if living with the individual, and the individual's
			 siblings under the age of nineteen if living with the individual.
(a)
												If the individual
			 (non-filer child) is married, the spouse of the individual is also included in
			 the household.
(b)
												If the individual (non-filer child) has children, the
			 individual's children are also included in the household.