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HomeMy WebLinkAboutappendix-c-guidelines-for-determining-family-size-v1.1.26Appendix C: Guidelines for Determining Family Size (January 2026) APPENDIX C: GUIDELINES FOR DETERMINING FAMILY SIZE FAMILY UNIT: A family unit is comprised of: 1. A married couple with common birth, adoptive or stepchild/ren* 2. An unmarried couple with one common birth and stepchild/ren* 3. A single adult with birth or adoptive child/ren* 4. A single adult over 19 years old 5. Any child under age 19 living at home or away at a school and claimed as a dependent, 6. A single adult with adoptive children, 7. A married couple with adoptive, or stepchildren, or 8. An unmarried couple with common birth children. *All child/ren should be under age 19 living at home or away at a school and claimed as a dependent Note: If there is more than one family unit living in the household—parents of adults, grandparents, uncles/aunts/cousins, etc.--each family will be considered a separate Family Unit. FAMILY INCOME: Family income includes income from all family members including public funds (i.e., SSI, Cal-Works, etc.) and cash income. Table 1 provides scenarios for determining family unit and family income to help determine HealthPAC eligibility. IN DETERMINING HealthPAC ELIGIBILITY, ELIGIBILITY OF ANY MEMBER IN THE FAMILY INTO OTHER HEALTH COVERAGE PROGRAMS, I.E., MEDI- CAL, COVERED CALIFORNIA, ETC. NEEDS TO BE PURSUED PRIOR TO ENROLLMENT INTO THE HealthPAC PROGRAM. Appendix C: Guidelines for Determining Family Size (January 2026) Table 1 SCENARIO FAMILY UNIT INCOME CONSIDERED (Refer to HealthPAC Liability Schedule to determine HealthPAC eligibility) 1. Single working male/female One Total gross income 2. Married working couple w/no children Two Total gross income 3. Married working couple with four children under age 19 living in household. Six Total gross income 4. Married couple whose elderly parents live with them, but parents have no income Two separate family units • Married couple = 2 • Elderly parents = 2 • Married couple’s gross income. • Elderly parents, aid in kind from adult children 5. Married couple receiving income for a foster child Two (foster parents only) Income of foster parents only. (Foster care allocation is not considered when determining gross monthly income.) 6. Grandparents taking care of grandchildren who are on CalWORKs. Two (grandparents only) Income of grandparents only. (CalWORKs income for grandchildren is not considered when determining gross monthly income.) 7. Married couple, husband receives SSI; wife needs health care and only income is husband’s SSI. Two Husband’s income from SSI. 8. Unmarried couple with no children; Male is working, female is not working and needs health care One • Female=1 Female needs to complete the HealthPAC Statement of Income and Residency 9. Unmarried couple with two (2) common children and two (2) children from other marriages/relationships. • Male works, female does not work. Female receives child support • Male or female presents for health care Six Income from male *Child support income only counts towards specific child