How many people are in the Household?
What is Medi-Cal’s definition?
Here’s four child pages for the major classifications of tax filing status – household size – composition for Medi-Cal enrollment, eligibility. The flowchart might be easier for some web visitors to use.
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
IRS and CPA Video on Tax Filing Status
ITA Interactive Tax Assistant - Filing Status
Check out the Household Size #FlowChart
below, or click on it to get a sharper image, for a simpler way of looking at the 42 CFR 435.603 rules.
InsuBuy International Medical Coverage –
Instant Quotes & Enrollment
Coverage for Travel - $50k Emergency under Medicare Medi Gap or MAPD Advantage may not be enough!
Our website is MUCH more than just
Pro Bono helping you with Medi-Cal
We've developed the Medi-Cal portion of our website, as many of our Covered CA clients unfortunately end up here, if their income drops below 133% of FPL, Federal Poverty Level, see the income chart.
We do not get a nickel, for this site or for helping people enroll in Medi-Cal, nor answering complex questions. When you have other questions or need coverage, take a look at our other websites:
MAGI Modified Adjusted Gross Income for Covered CA Subsidies and Enhanced Silver citing IRS 26 USC § 151 appears to only apply to those actually on your tax return. Please contact competent tax counsel. We do not give tax or legal advise. Volunteer Income Tax Assistance VITA
Federal regulatory reference is 42 CFR 435.603
Western Poverty Law on Tax Filer Rules
Orange County Covered OC FAQ # 5 – doesn’t really answer your question.
Disability Benefits 101 – Medi-Cal the Details
My Medi-Cal
How to get the Health Care You Need
24 pages
Smart Phones - try turning sideways to view pdf better
- Medi Cal Explained CHCF
- 10 Essential Health Benefits
- Our Webpage onMedi Cal Benefits
- Western Poverty Law - Exact Legal Rules on Coverage for Low Income Californian's
Our Webpage on
COVID 19
Get Instant Term Life Quote
Set up a phone, skype or face to face consultation
Tools to help you figure out how much you should get
Life Insurance Buyers Guide
How much life insurance you really need?
Life Screening Form
Please complete & return and we'll search and consult for you. Or try this one from NAAIP.org
As this pertains to whether or not I will have health coverage after I turn 26 this October, I must ask:
Does my grandma count as a member of my household for the purposes of signing up for Medi-cal?
From what I gather, she did not adopt me as her child, but rather took legal guardianship of me. As I currently have no income, I do not know if I qualify as a tax dependent under her.
A lot of this stuff is incredibly confusing to me, and that’s the best way my brain could process it.
If I don’t qualify as a tax dependent, then I qualify for Medical. If I do qualify as a tax dependent, do I still qualify for low cost or free Medical?
Try using the Interactive Tax Assistant Above.
See IRS Publication 501 above
26 US Code Section 152 Definition Dependent
https://www.law.cornell.edu/uscode/text/26/152
Western Poverty Law Page 4.151
https://wclp.org/wp-content/uploads/2016/06/Western_Center_2016_Health_Care_Eligibility_Guide_Full_rev.1.pdf#page=165
Try asking VITA above if you’re a dependent.
What is your Grandma’s income, you might qualify anyway.
How about Covered CA with subsidies?
Get quote
http://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?license_no=0596610
How about just applying for Medi-Cal and see what happens.
If you qualify for Covered CA how about appointing us as your broker, no extra charge. That way we get compensated for helping you.
Are you disabled?
I am currently living at home and am not claimed as a dependent under my parents and they have their own health insurance plans.
I have a job, but don’t make much, and filed my own taxes last year.
My automatic redetermination renewal letter in the mail list my household as 1 for myself.
Is this correct even though I’m living at home with my parents but not claimed on their taxes?
Here’s our webpage on filing taxes, but not claimed as a dependent.
Are you a full time student?
So, no, your parents are not part of your household.
Thank you for your quick response Steve! I was worried this information was incorrect.
No I am currently not a student at all. However, if i do end up going back to school and am still living at home when that happens, would there be a change to that household number to 3?
Would you still be filing your own taxes?
Would you have income?
Would your parents claim a deduction?
How old are you?
Scroll up the screen to the full chart. You can probably go through the options as well as I.
I receive medi-cal in the state of California
i’ve been living married but separated but last year 2019 I stayed as a roommate with my husband 2-3 weeks out the month so I can see my granddaughter.
I don’t have any income currently fighting SSI so I don’t pay any bills.
If he filed married filing jointly will that effect my med-cal?
Your questions are rather complex for someone who doesn’t get compensated to help people with Medi Cal.
Here’s the reference material:
Medi Cal is automatic if you have SSI Supplemental Security Benefits
SSI Income & Asset Limits
Our webpage on mandate to file jointly
Our webpage on separated spouses – I don’t think you’ll qualify
How many people are in your husband’s tax family? What is the income? Chart
How about getting a subsidized Covered CA quote? No extra charge for agent support.
Where does your husband have his Health Insurance? Can he add you on their?
See link above for VITA Volunteers for Taxes. I doubt they will know, but Covered CA prohibits agents from giving tax advice.
if my husband who is disabled get divorced and file separate tax returns as single
do i have to disclose my income to qualify for him to qualify for medi-cal
Since you are not claiming him as a dependant, I don’t see any reason that you would need to. You’re not in the same household, nor married. Is your divorce final? Step 5 in flow chart. Note that Medi-Cal is a little more liberal than Covered CA! I think this is asking a lot of Covered CA agents, who don’t get paid or trained to help people with Medi Cal!
See also not-claimed-dependent-f-3
Please note that Covered CA prohibits agents and their employees from giving tax advice. We are only pointing out the law and DHCS’s flow chart. Try VITA
i live in a room rental
i buy my own food
if i apply for calfresh i am on ssi in california do i have to list all of the roomates?
if you do not know is there anyplace that would?
Your county social worker gets paid BIG BUCKS to help you. We don’t get paid at all. Go ask them. Here’s our Medi Cal contact page https://medi-cal.healthreformquotes.com/medi-cal-introduction/enroll-online-los-angeles/contact-info/
We do not like the tone of your question. We don’t get paid to work on this, so please don’t expect an immediate answer. We have our personal lives and business to take care of. We can look up everything and don’t like it implied that we don’t know or can’t find an answer.
We are not allowed to give tax or legal advice. If you follow the chart above, based on Section 435.603 f of Medi Cal regulations, I think you will see that since you are not filing taxes together, they are not part of your household.
Steve,
I want to give you my greatest gratitude for everything you’ve assisted us with and how knowledgeable you are.
I’m truly grateful for you.
Rachel F
i am on SSDI dac [disabled adult child] under my fathers record
i do NOT file taxes
will i get a 1095b? Proof of Insurance from Medi Cal?
does the 1095b have anything to do with my annual medi-cal/medicaid re-newal?
or is the 1095 something seperate?
Yes, your supposed to get a 1095 B from Medi-Cal to show that you had coverage so you don’t pay the fine for not having health insurance. Learn more about 1095 B here.
I don’t see that the 1095 B is relevant to redetermination. If you were required to file taxes, then of course you would have to file the 1095 b with your 1040, line 61 Instructions Page 51
but how would i fill it out considering i dont pay taxes on ssdi?
and when i was on SSI shoudnt i have gotten a 1095b then too?
i NEVER did you sure that applys to SSDI medi-cal for people like me who dont file taxes?
the form seems to be for people who file taxes as far as i know
i do NOT file taxes
Then just throw the form away!
well i dont want to toss it when it comes only to find out for soem retarded reason they still want it back
Please when posting do not include your last name, when asking personal questions. There are issues with Privacy – PHI and I don’t want anyone from the Government bothering me. It’s bad enough that Covered CA threatened to terminate my contract as they don’t think I do enough Pro Bono work to facilitate enrollment into Medi-Cal.
Please wait till I’m done answering your question, before asking new questions
Please, when I refer you to another page that deals with the 1095 B form, ask your question there.
Please do not ask me if I’m sure about anything. I’m not a tax attorney or CPA. Please see the link I referred to where I gave you all the information about the 1095 form and what Medi-Cal wrote about the 1095 form and their FAQ’s.
Please, before asking MORE questions, would you read the information that I give you. To my knowledge there is NOTHING for you to fill out on the 1095 B form. You use it when you file your taxes for line 61 of the 1040. If you don’t need the form, throw it away!
My boyfriend is currently going to school and has no health insurance. I however have Medi Cal. We live together. Is there a way to add him to my Medi cal?
Doesn’t sound like you are in the same household as you didn’t say you are writing him off as a dependent. If he has no income, he can apply for Medi-Cal on his own. Here’s our Medi-Cal contact page Link to Los Angeles Medi Cal website & enrollment, check the child pages for a few other counties.
My 71 year old mother-in-law is immigrating to the US via green card, she will be filing her own tax returns (zero income) and no one will be claiming her as a dependent, nor will she be claiming anyone as a dependent.
She will live in my home with my wife, myself and 3 year old daughter.
In filling out the Medi-Cal application, it’s asking about EVERYONE in the ‘household’, even if they don’t want insurance, including roommates and boyfriends and girlfriends and also asking for sensitive income information.
Are myself, my wife and child considered “living in her household”?
Do I need to provide my tax information?
I am minimally insured through work as well as my wife and daughter but they won’t add her on as a mother-in-law.
Very confused.
Thanks!
Oh sorry for the trouble I re-read some of the earlier posts and based on what you said, my mother-in-law’s household size would be ONE (herself only), she in essence is just someone living in my home for free and filing her own tax returns, her Medi-Cal eligibility has nothing to do with me, my wife or child since she is not our dependent,
cheers.
1. My girlfriend lives with me and we have a child together. She stays home to take care of our son. She teaches a class for children 2 hours a week but she earns less than $4000/year.
2. She’s had medi-cal for some time now but now they’re asking about my income and any child support payments my girlfriend receives.
3. It seems like they’re trying to get me to pay for child support when I already support both her and my child under one roof.
4. She’s worried she will no longer be eligible for medi-cal although based on my research that does not seem to be the case.
5. My son and I have insurance through my employer. I will be claiming my son as a dependent on my tax return but will NOT be claiming her.
6. Is she still eligible?
7. Do I need to fill out the child support paperwork?
7. I would say yes. Please review the research below. Namely, bartering. She might well be earning an income that would no longer qualify for Medi-Cal, see chart. Is she a household of one or two?
Also, it’s quite likely that you earn more $$ than I as a Covered CA agent, mandated to “facilitate” enrollment into Medi-Cal and don’t even get paid to do that.
Why do I and all the other taxpayers have to support your girlfriend’s health insurance when IMHO you ought to just marry her and pay all her and your child’s expenses.
2 & 7 – Here’s information on child support and Medi-Cal
Medi-Cal eligibility procedure manual See page 37 about value of in kind for food, utilities, housing, clothing, this manual was written in the 80’s so add inflation.
Child Support Handbook
What if the child is covered under Medi-Cal?
Medi-Cal is not considered a substitute for private health care coverage. The employer must still comply with the medical withholding order.
IRS.gov In kind Contributions
IRS.gov Bartering
question i thought i would be too high of a income for disabled medi-cal because i get 1368, the medi-cal lady said no i would not because the 1368 comes off my fathers record not mine, reason i ask is if it it is same for the medicaire savings/extra help programs i rather switch to them medi-cal is to fricking nosey, medicaire extra help/savings programs all they ask is anyone related to you or your wife thats IT so if my 1368 would not count against me for those programs i would just drop medi-cal
For an individual who lost SSI eligibility because of the initial entitlement to a DAC benefit, the entire amount of the DAC benefit is disregarded in the determination of countable income, including any
subsequent increases in the benefit. When ineligibility for SSI was due to an increase in the DAC benefit, the amount of DAC benefits received in the month prior to the termination of SSI is the amount of DAC benefits that are counted in determining eligibility. Any subsequent increase(s) in DAC benefits is disregarded from here…….
https://wclp.org/wp-content/uploads/2016/06/WesternCenter_2016_HCGuide_Chapter3_rev.1.pdf there as well about DAC
Thank you very much for your help in getting the most up to date and relevant materials.
We’ve now added the ability to upload pdf documents, in case you have a pdf but not a web address for something.
Web addresses are preferred. That way we don’t have to host the material.
My boyfriend does not file taxes and is living with me. I fully support him while he gets a business started. He is filing for Medi-Cal. What is his household size?
Are you taking the deduction for him on your taxes?
If you are not, then he can be a non-filer and the household would be 1, till you get married.
If you are, then: * Household size consists of individual and the taxpayer and all other persons whom the taxpayer expects to claim as a tax dependent step # 4 in the chart in the upper right hand corner
i do NOT file taxes but they sent me this form https://www.co.shasta.ca.us/docs/libraries/hhsa-docs/coveredshasta/request-for-tax-household-information.pdf?sfvrsn=0 the form says in the instructions to add everyone in my household
BUT in the household size chart at the top of this page it says if your a non filer to only include people who are related to me
i rent a room. im not related to them or anything
so do i just list myself and thats it?
Thank you very much for sending the actual form that you are asking about.
The key term as you point out is “household” Page 1 Section what we need:
We need information about each person living in your household or listed on your tax return
I suggest that you just write across the form that you do not have anyone in your household. Tell them that you qualify as a non-filer – see above chart and that you just rent a room from people that you are not related to.
Many counties have online filing. You might check and then when you do let them know, it all gets done faster.
If you want to double check directly with Medi-Cal here’s our contact page for them.
P.S. One reason Medi-Cal asks so many questions, is that there are tons of programs and benefits that Medi-Cal has, here’s even more and they are mandated to help people enroll, even if they don’t know they qualify for anything.
ok but in plain english do i need to list anyone else or no? i dont file taxes i am on no one elses taxes so for this form https://www.co.shasta.ca.us/docs/libraries/hhsa-docs/coveredshasta/request-for-tax-household-information.pdf?sfvrsn=0 do i need to fill out for anyone else or just fill out and list myself and thats it?
No you don’t need to list anyone else
I’m just suggesting that you gI’ve Medi-Cal an explanation so that they’re clear on why you’re not answering the question
well if you read the form it says to fill out another form for household members doesnt have a line to add them on this form anyway, near as i can see let me look, NOPE doesnt have any lines to add second person just says up top to fill out another for anyone else
Right so if you have extra household members just print off an extra page for the number of members that you have in your household
For you though it’s moot
you don’t have anyone in your household
she said i could fax it in but she is closed till tuesday so i can just fill out for me? she said the whole tax thing she said put does not apply and at bottom gives you option to renew using your tax info she said click box says do not use tax info, i didnt notice at time or i would have asked about other people and as far as i can remember she didnt mention anyone else
Since you’re concerned I would go ahead and try faxing today because fax machines are usually left on 24/7. Understanding fax machine whether it’s yours or you go to FedEx or something you should Biella get a receipt that your fax went through
In my opinion I would go ahead and say please use tax information because you’re giving them five years in the future to use tax information and whatever information they can get to renew your coverage
I would give an explanation and just say I’m not required to file a tax return And haven’t filed one since ….
i would but i hadnt decided whether to mail it or fax it so i didnt ask her, her fax number
Try these links if u r in Alameda County
https://alamedasocialservices.org/public/services/CarsVru/CARsWeb.htm
https://www.alamedasocialservices.org/public/index.cfm
those links do me no good because my case is in los angeles county
Where in Los Angeles?
https://medi-cal.healthreformquotes.com/medi-cal-introduction/enroll-online-los-angeles/
im scared to DEATH because if tomorrow i just try and turn in the tax paper for myself and she says i have to get the roomates to im FUCKED no idea why but my landlord/roomate was like we are not filling that out, if you list us on pack up and MOVE so if that happens or if she doesnt ask but their computer system notices people at that address im SCREWED
We’ve gone through that you’ve got the non-filer exemption number three in the law and then wherever it is on the chart so there’s no way they’re going to make you get information on your roommates
Besides that you don’t have to get the information on your roommates you pointed out the pickle amendment which says that when you transfer from SSI to assess DI they can’t kick you out
that pages sounds like they dont care and they will try and make you, i guess i will see tomorrow i wish 9am would hurry up and come, if she lets me im going to go to office depot print it out and fill it out and fax it to her
so in your opinion thats just a 1 size fits all paper and doesnt apply to certain people who are non filers? also whats funny is even for taxes go read it, even under taxes your household is anyone releated/a dependent of you and thats it
Yes, that’s why in the very beginning I suggested that you just write on the paper that you just rent a room and you don’t have any relatives or anyone on your tax return living there
They just have one form so write them a separate letter or do as I suggested put the answers right on the form
I have a family of 4 including my spouse and 2 kids under 10.
My mother aged 71 just immigrated to US recently as a permanent resident. She is a widow and is currently living with us. She does not work and has no income.
Does she qualify as a separate household for the purpose of Medi-Cal eligibility?
I do not intend to claim her as a dependent.
It’s my understanding that even if you did claim her as a dependent, under the non-filer rules above F 2, she would be in a household on her own.
By herself and not filing, it’s my understanding under F 3 that she would be in her own household of one.
This is pro bono work. Please double check on your own, seek competent tax or legal counsel, paid Medi-Cal Social Workers and verify in official Medi-Cal brochures. We link to many of them.
She may also qualify for the aged and disabled program.
I am 55 and my kids receive Medi- Cal and I do not.
Is their Medi-Cal coverage subject to estate recovery, under My Estate when I die?
I know If I were receiving Medi-Cal it would be but I cannot find any info concerning if they are receiving it and I am over 55.
No. A new law SB 833 §14009.5. Effective 1.1.2017 changed estate recovery for health insurance. Read our webpage on estate recovery and very carefully. If you still have questions, please ask on the most relevant page.
I live with my two teenage children (from a previous marriage and we are since divorced), my 2-year old daughter and her father, my EX-boyfriend. Him and I are no longer in a relationship and do not share food or expenses.
I receive wage income and he receives unemployment.
I let him live rent free because I do not have a babysitter and he watches her while I work.
Do we qualify separately for calfresh [food stamps, wic?] and medi-cal or are we considered part of the same household?
See the chart in the main body of this page. How are you filing taxes? Your not married. Your not taking him as a dependent, right? Is he actively looking for work?
My guess would be that you are separate households. Check with your social worker.
What appears to be the relevant section.
You are correct on all counts. Thank you. Your information looks accurate but I will definitely check.
I live with my son and daughter in law; we live with them rent free and they provide food/clothes/basic necessities for us. They also claim us on their tax return.
My daughter in law doesn’t disclosure their income to us and would have us move out if they had to pay for our insurance.
Am I required to list them as family?
See above about the non-filer exemption
Sorry i don’t understand, so we have to list the information since they claim us as dependents on their tax return…..
i didn’t understand the legal writing terms
Sorry, I can’t find a simple plain English answer for your question. Also, I don’t know exactly which form and question number you are referring too. Try contacting Medi-Cal. I’m not an authorized Medi-Cal Social Worker and if I answer the question wrong, it might subject me to loss of license, lawsuits, jail, who knows.
My 19 year old daughter and her baby live with us and have Medi-Cal. Her 18 year old boyfriend just started staying with us so they can be together with the baby. Medi-Cal now wants his income info. i am trying to find what the income guidelines are for a child to qualify for medi-cal with two parents. Does anyone know? I would hate for baby to lose benefits.
Income chart
https://taxcredits.healthreformquotes.com/covered-ca-income-chart/
Child support and health insurance
http://farzadlaw.com/orange-county-child-support-lawyers/california-child-support-health-insurance/
La county child support finding parents
http://cssd.lacounty.gov/child-support-process/
https://childsupport.ca.gov/publications/
My husband is a full time student and i have a part time work and we also we have 4 months old baby. We currently live for free in my husband’s parent’s house
In filling out the additional income and property information needed for medi-cal
should i check the box that states a member of the household is a child who is being cared for by a relative?
Please let us know exactly what Medi-Cal form you are talking about?
Do you mean MC 604 ADDITIONAL INCOME AND PROPERTY INFORMATION NEEDED FOR MEDI-CAL
Please check here if a member of the household is a child who is being cared for by a relative, other than a parent,
who also lives in the household.
If you checked this box, please list:
The name of the Caretaker Relative:
The children being cared for:
I don’t see any reason why you wouldn’t list it. There may be additional benefits that you are entitled to. Cal Works – Child Care?
1. My stepdaughter is 13 and lives with me. Her mother is deceased and the father is unknown and unnamed on her birth certificate.
2. I was told that I cannot claim her as a dependent
3. and I cannot include her on my insurance and work,
4. yet my income makes her ineligible for Medi-Cal?
5. Even though Covered California says that her household income is $0?
First off, I do not like hearsay. Someone telling me what someone else said. I prefer to see actual documents.
2. Here’s the actual code section 152 dependent to see if you can take your step daughter as a dependent. Notice 2008-5 which explains it further. See also publication 17. Try this IRS Tool. I just used this tool and it said yes. Do NOT take my word for it. Use the tool yourself, print out the answer and tell the “Rando’s” who said you can’t take her as a dependent to check the entire law and rules first, before giving you the wrong answer.
IMHO since you are paying more that 1/2 of her support, you can take her as a dependent. Please contact competent tax counsel!
4. If you can’t claim your step daughter as a dependent, they she would be on her own and qualify individually.
3. How about adopting the child? Where you married to the Mother? Has a court named you as the legal guardian? More on the Insurance Company definition of dependent.
Check out the comments below on the non-filer exemption. View the flow chart and this article from George Town University, or Western Poverty Page 2.33.
I live with my boyfriend. He pays the mortgage. I pay the the utilities. It about evens out. We don’t claim each other on our taxes. What is my household size? a 1 or a 2? I am trying to apply for medi-cal
See the flow chart above right. Step 3 – No, since neither of you are claiming the other as a dependent.
* Household size consists of the individual and all persons whom such individual expects to claim as a tax dependent.
*Household size = Total number of persons counted in household composition
I was trying to get clarification on Bryanna above. Are you saying she would be a household size of 1 or 2 then based on the flowchart? Did you mean she would be a HH size of one since she didn’t claim him as a dependent? Thank you.
It’s a household of one, as they are both filing as singles. They are not married.
I am 20 years old and I am going to school full time. I stay with my boyfriend. He does not have his own place so I technically stay at his grandparents house. I do not pay any rent but i work part time and pay for all of my own things including food. What do I put down for my household?
Sounds to me like your a household of one. Are you filing your own 1040 tax return or will the Grandma count you as a dependent, based on free rent? Did you check the flow chart above?
My grandchildren live with me. I am their legal guardian and I claim them on my taxes as dependents. Medi cal determined that they were each their own separate household and said they were eligible for medical. Why?
I don’t like to deal with hearsay. Would you please send any actual papers or documents that Medi-Cal sent you.
How old are the children?
What is your income?
Did you want to purchase health insurance for them without Covered CA subsidies?
What health insurance do you have?
What coverage did the children have before?
It’s my opinion that if the grandkids just lost Covered CA that they have a special enrollment period, if you want to buy coverage and pay an unsubsidizd premium.
Click here to get quotes for the kids.
I don’t get paid to help the public with Medi-Cal…
In reply to Mary who claims her grandchildren as tax dependents…
If you look at the flow chart it explains it. They meet what is called a Non-filer exemption:
Does the individual meet one of the following exceptions?
The tax dependent is-
1. Someone other than the spouse or child (biological, adopted, or step; minor or adult) of the taxpayer.
Since they are not your spouse or child, they meet this exemption.
Non‐Filer Rules-
Household size consists of the individual plus the following people living with the individual:
Individual’s spouse;
Individual’s children under age 19 (natural, adopted and step), or if full‐time student, under age 21;
For individuals under age 19, or if full‐time student, under age 21:
Individual’s parents (natural, adopted and step); and
Individual’s siblings under age 19 (natural, adopted and step), or if full‐time student, under age
21
Household size = 1 + total number of people listed above living with the individual.
Basically, as you are not the spouse, parent, child, or sibling of your grandchildren you do not count as a part of their household and so your income does not count towards them, giving them $0 income.
Thank you very much for pointing out the non-filer rules, clearly shown in the flow chart. I will now point that out to another person who asked a similar question.