For Marketplace and most Medicaid/CHIP programs, “household” usually means your tax household for the year you want coverage. Use who you expect to list on your federal tax return for that year.
Include
You
Your spouse if you are married and will file a joint return
Anyone you will claim as a tax dependent (children, adopted or foster children you claim, and other relatives you will claim)
Do not include
Roommates or housemates you do not claim
A partner you are not married to and do not claim
Adult children who file their own tax return and whom you will not claim
Relatives you help financially but will not claim
Special cases
Married filing separately: generally you must file a joint return to qualify for Marketplace premium tax credits. Exceptions may apply in cases of domestic abuse or spousal abandonment, or if you qualify to file as Head of Household with a dependent.
Children in shared custody: the child counts in the household of the person who will claim them for that tax year. If parents alternate years, the household size changes accordingly.
College students: if you will claim the student as a dependent, they are in your household even if they live away for school. If they file their own taxes and you will not claim them, they are their own household.
Pregnancy: Marketplace household is based on current tax household. Some state Medicaid/CHIP programs may count the unborn child or children for eligibility.
Newborns and adoptions: once you will claim the child for that tax year, add them to your application and report the change right away.
Dependents with income: if you will claim them, include their taxable income when reporting total household income.
Non-citizen family members: include everyone you will claim, regardless of immigration status. Only people applying for coverage need to share immigration information.
Separated spouses: if you are married but living apart, review whether you can file as Head of Household with a qualifying dependent. If not filing jointly and no exception applies, Marketplace tax credits may not be available.
Why this matters
Your household size and total modified adjusted gross income determine eligibility for Medicaid/CHIP and your Marketplace savings.
Quick tip
Base your application on the tax return you expect to file for the coverage year. If your filing plans change, update your application as soon as possible. If you have questions, please call our team of licensed Consumer Advocates at 855-772-2663.