When Applying for Medicaid What is a Household

When applying for Medicaid, defining household is a critical step. A household includes all people who live together and share income and expenses. Some states also include people who don’t live together but share resources. It’s important to report all household members, even those who are not applying for Medicaid. This is because Medicaid uses household income and assets to determine eligibility. Providing accurate information about your household can help ensure that you get the coverage you need.

Income and Assets of All Household Members

When determining eligibility for Medicaid, the income and assets of all household members are taken into account. This includes the applicant, their spouse, and any dependent children. The following provides an overview of what is considered income and assets, as well as how they are evaluated.

Income

  • Earned Income: This includes wages, salaries, tips, commissions, and self-employment income.
  • Unearned Income: This includes interest, dividends, pensions, Social Security benefits, and alimony.
  • In-Kind Income: This includes food stamps, housing assistance, and other non-cash benefits.

Assets

  • Cash and Bank Accounts: This includes checking accounts, savings accounts, and certificates of deposit.
  • Investments: This includes stocks, bonds, mutual funds, and retirement accounts.
  • Real Estate: This includes the applicant’s primary residence and any other real estate holdings.
  • Vehicles: This includes cars, trucks, and motorcycles.
  • Personal Property: This includes jewelry, antiques, and other valuable items.

It’s important to note that not all income and assets are counted when determining Medicaid eligibility. There are certain exclusions and deductions that can be applied. For example, some states allow a certain amount of earned income to be disregarded, and there are also limits on the value of assets that can be counted.

Medicaid Income and Asset Limits
StateIncome LimitAsset Limit
California$1,573 per month for an individual$2,000 for an individual
Texas$1,383 per month for an individual$2,000 for an individual
New York$1,569 per month for an individual$2,500 for an individual

Relationship to the Applicant

One of the criteria for Medicaid eligibility is the relationship of the applicant to the head of the household. To determine eligibility, Medicaid considers all members of the applicant’s household, including their relationship to the applicant.

Members of the Household

  • Applicant
  • Spouse
  • Children under age 19
  • Children age 19 or over who are disabled
  • Parents of a child under age 19 who is applying for Medicaid
  • Siblings of a child under age 19 who is applying for Medicaid
  • Grandchildren of an eligible parent or grandparent
  • Unborn children
  • Stepchildren
  • Foster children
  • Legal wards

The relationship of the applicant to the head of the household determines if the applicant’s income and assets are counted when determining Medicaid eligibility. In general, the income and assets of the applicant’s spouse and dependent children are counted, while the income and assets of other household members are not.

Relationship to ApplicantIncome and Assets Counted
SpouseYes
Dependent childrenYes
Other household membersNo

There are some exceptions to these general rules. For example, the income and assets of a parent or grandparent are not counted when determining the Medicaid eligibility of a child who is applying for Medicaid. Additionally, the income and assets of a child are not counted when determining the Medicaid eligibility of a parent or grandparent.

Living in the Same Address as the Applicant

In the context of applying for Medicaid, a household is defined as a group of people who live together and share income and expenses. This includes individuals who are related by blood, marriage, or adoption, as well as unrelated individuals who share a common living arrangement. In general, all individuals who live in the same household with the applicant will be considered members of the applicant’s household for purposes of determining Medicaid eligibility.

Who is Considered a Household Member?

  • Spouse
  • Children under the age of 19
  • Children under the age of 21 who are full-time students
  • Children who are disabled and receiving Supplemental Security Income (SSI)
  • Parents of the applicant who are living with the applicant
  • Siblings of the applicant who are living with the applicant
  • Unrelated individuals who share a common living arrangement with the applicant and who are financially interdependent with the applicant

Exemptions to the Household Definition

There are a few exceptions to the general rule that all individuals who live in the same household with the applicant will be considered members of the applicant’s household. These exceptions include:

  • Individuals who are institutionalized
  • Individuals who are receiving home and community-based services
  • Individuals who are enrolled in a managed care plan
  • Individuals who are living in a nursing home
  • Individuals who are living in a residential care facility

Income and Resources of Household Members

The income and resources of all household members are considered when determining Medicaid eligibility. This includes income from employment, Social Security benefits, SSI benefits, and other sources. Resources include cash, bank accounts, stocks, bonds, and real estate.

Income and Resource Limits for Medicaid Eligibility
Household SizeIncome LimitResource Limit
1$1,563$2,500
2$2,110$3,000
3$2,657$3,500
4$3,204$4,000
5$3,751$4,500
6$4,298$5,000

The income and resource limits for Medicaid eligibility vary from state to state. To learn more about the Medicaid eligibility requirements in your state, you can contact your state Medicaid office.

What is a Household When Applying for Medicaid?

A household is a group of individuals who live together and share the same income and expenses. For Medicaid eligibility purposes, a household includes the applicant, as well as their spouse, dependent children, and other individuals who are financially related to the applicant. These individuals are known as non-excludable applicants and must be included in the Medicaid household when determining eligibility.

Non-Excludable Applicants

  • Spouse
  • Dependent children, including adopted children and stepchildren
  • Children under age 21 who are full-time students
  • Children under age 19 who are disabled
  • Parents and grandparents who live with the applicant and are financially dependent on the applicant
  • Siblings who live with the applicant and are financially dependent on the applicant

In some cases, individuals who are not related to the applicant may be considered non-excludable applicants. These individuals include:

  • Foster children
  • Legal wards
  • In-laws
  • Live-in partners

The income and assets of all non-excludable applicants are counted when determining Medicaid eligibility. This means that the income and assets of the applicant’s spouse, children, and other financially dependent individuals will be included in the calculation of the applicant’s Medicaid eligibility.

Income and Asset Limits for Medicaid
Household SizeIncome LimitAsset Limit
1$2,830 per month$2,000
2$4,047 per month$3,000
3$5,264 per month$4,000
4$6,481 per month$5,000
5$7,698 per month$6,000

The income and asset limits for Medicaid vary by state. In general, the higher the household size, the higher the income and asset limits.

Hey there, readers! I hope this article helped shed some light on what constitutes a household when it comes to applying for Medicaid. I know this stuff can get confusing, so I tried to break it down in a clear and concise way. If you still have questions, feel free to reach out to your local Medicaid office. They’re there to help! Thanks for reading, and be sure to check back soon for more informative articles on all things Medicaid. Take care!