Income Calculations

How do I calculate my household income?

Not sure how to calculate your income when applying for health coverage?  Here’s a quick guide:

Qualified Health Plans

Qualified Health Plans are available to most Vermonters, and many people are eligible for financial help paying for coverage. To find out whether you qualify to get financial help, you’ll need to understand your annual projected income. This is not based on your assets (like owning a house, or business) and doesn’t consider your cost of living. Only your sources of income are counted.

So, who’s income should you to gather? The first question to ask yourself is—will I be filing taxes this year? If the answer is yes, think about everyone included in your tax filing household. If you are married, you must file jointly in order to get financial help. If you are married and filing jointly, you’ll need to include the income of yourself and your spouse. If you have children you claim as dependents on your taxes who are working (even if it’s only part-time) you’ll also need to include their income.

If you do not intend to file taxes, you may not be able to get financial help unless you are under the age of 26 and are claimed as a dependent on someone else’s taxes. However, if you are over the age of 26 and do not file taxes, you may be able to receive financial help if certain conditions apply. Please contact Vermont Health Connect for more details.

Many people live with other people who are not included in their tax filing household. If you have a roommate or partner who is not included in your taxes, you do not have to claim their income when you apply for financial help. You only need to report income for members of your tax filing household.

Even if you live with your parents, you could still get financial help—depending on your age and tax filing status. If you are under the age of 26 and your parents claim you on their taxes, you can be covered by their plan. Even if you file taxes separately, you have the right to be included on your parent’s plan if you are under the age of 26. In this case, your financial help will be determined separately, because you have a separate tax filing household. However, your financial help can be applied to your parents’ plan, in addition to the financial help they receive as a separate tax filing household. Your financial help, plus your parents’ financial help will be combined and applied to the same health plan.

If you are over the age of 26, you cannot be included in your parents’ insurance plan—even if they still claim you as a dependent on their taxes. If you are over the age of 26 and claimed as a dependent on your parents’ taxes, you may purchase insurance through Vermont Health Connect but you may not get financial help. However, if you are over the age of 26 and you are not claimed as a dependent on your parents’ taxes, you may be eligible to receive financial help based on your own reported income. It doesn’t matter whether you live in the same house with your parents, as long as you file taxes separately.

Medicaid for Children and Adults

Your eligibility for Medicaid for Children and Adults (MCA) is based on your household’s current monthly income. MCA eligibility doesn’t consider your assets (like owning a house, or business) or your cost of living. Only your taxable income is counted, plus social security and tax-exempt income. Supplemental Security Income (SSI) is not considered.

Your income should be based on the monthly income of everyone in your tax filing household. If you do not file taxes and are not claimed as a dependent on anyone else’s taxes, your Medicaid household includes the income for you, your spouse and any children under the age of 19 (21 if a full-time student.) You should include income for all members of your household in your application.

If you do file taxes, determine whether you’ll be included as a dependent on someone else’s taxes. If not, your household includes the income for you, your spouse (if filing jointly) and any children under the age of 19 (21 if a full-time student.) You should include income for all members of your household in your application.

If you are included as a dependent on someone else’s taxes, determine if any of the following applies to you:

  • You are under age 19 (or under 21 if a full-time student) living with both parents if your parents do not expect to file a joint tax return.
  • You are under age 19 (or under 21 if a full-time student) who expects to be claimed as a dependent by a non-custodial parent.
  • You expect to be claimed as a tax dependent by someone other than a spouse or parent.

If any of the above are true, your tax household includes you, your spouse and any children under age 19. If you are under age 19 yourself, your parents and siblings under age 19 are included in your Medicaid household, as long as they live with you.

If you are applying for MCA coverage while pregnant, add the number of children you expect to deliver to the household size determined by the above.

Medicaid for the Aged Blind and Disabled

For information about Medicaid for the Aged, Blind and Disabled, click here.