For the health insurance marketplace, a household is typically defined as the tax filer, spouse, and dependents. Under this definition of household, your spouse has to be someone you are legally married to, and dependents can only be those claimed on your taxes as a tax dependent. When applying for Medicaid you include your spouse and all dependents regardless of whether or not they need health insurance.
Some states provide a slightly different definition of household, so it is important to use this as a guide but to verify with your specific state who is considered part of your household. Additionally, when applying, you will need to provide verification of each household member. Depending on the relationship, verification may include birth certificates, social security cards, a marriage certificate, custody agreements, or another form of identification.
Due to the complex nature of family relationships, there may still be questions whether or not you should count someone as part of your household. Here is a quick guide to help. If you have a specific question regarding whether or not someone is part of your household, you can also contact your county Medicaid office and ask.
Check Your Eligibility
|Relationship||Are they part of your household?|
|Dependent children||Yes. You can also count dependent children as part of your household. This includes foster and adopted children that are living with you.|
|Children you share custody of with another parent||This will depend on your arrangements with the other parent. Regardless of whom the child spends more time with, only the parent that claims the child on their taxes can count the child as part of their household.|
|Children under the age of 26 that are not dependents||They can be included as part of your household if you want them to be covered under a Marketplace plan.|
|Children under the age of 21 that you care for||Every child under the age of 21 that you are taking care of, even if they are not listed as dependents on your taxes can be included as part of your household.|
|Unborn children||Do not list unborn children as part of your household. Pregnant women are listed as such for proper coverage. You have up to 60 days to enroll your newborn.|
|Dependent Parents||If you are claiming our parents as dependents on your taxes, you can include them as part of your household.|
|Dependent siblings or other dependent relatives||Similarly to parents, if you claim sibling or another relative as a dependent on your taxes, you can include them as part of your household.|
|Spouse||Your legal spouse is part of your household. It does not matter if your spouse is the same or opposite sex.|
|Spouse you are not living with||As long as you are legally married, you can claim your spouse as part of your household.|
|Legally separated or divorced spouse||You cannot include a spouse as part of your household if you are divorced or legally separated.|
|Unmarried domestic partner||You can include an unmarried partner if you have children together or if you claim your partner as a dependent on your taxes.|
|Roommate||A roommate cannot be included as part of your household unless the roommate is covered by some other category.|