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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Household Includes Grandparents?

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Question: 40 year old and 2 kids live with both parents/grandparents. 40 year old is currently unemployed with no income. Parents do not claim the 40 year old or the kids as dependents as she intends to work again soon. The question is, are there 5 in the household or 3 if the parents/grandparents do not claim the others as dependents? If the answer is 5, are we supposed to obtain income information from the parents/grandparents even though they have nothing to do with the insurance coverage?

Answer: The mom and 2 kids apply as a household of three and use her income alone for eligibility determination. Remember this general rule, “If you file together, you shop together”.


Year 2014 Advanced Premium Tax Credits, Cost Sharing Reductions, and Medi-Cal Eligibility will be based on year 2014 income. However, year 2014 is unknown and can only be estimated at this time. The Mom and two kids (“household”) can input estimated 2014 income or the most recent income reported to the IRS, which is most likely to be found on line 37 of her year 2012 form 1040.

Phil you did not answer her question, the mom with the two kids, is unemployed and has no income. So does she input her come from last year income tax form?

That is what she needs to know.

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