Determining Your Household for ObamaCare Coverage and Cost Assistance

In general, when determining who your plan should cover, your household includes you, your spouse, and your tax dependents (for example, your children). With that said, there are some special rules that apply.[1]

Here are the basic rules for who you should include in your coverage family and for who to include in your household for cost assistance.

  • Your coverage family and tax family will generally be the same.
  • You should include your spouse if you’re legally married.
  • If you plan to claim someone as a tax dependent for the year, include them.
  • If you won’t claim them as a tax dependent, don’t include them.
  • For cost assistance specifically, include your spouse and tax dependents even if they don’t need health coverage.

The table below covers all the special situations for who to include in your house or coverage family.

Who to include in your household
Relationship Include in household? Notes
Dependent children, including adopted and foster children Yes Include any child you’ll claim as a tax dependent, regardless of age.
Children, shared custody Sometimes Include children whose custody you share only during years you claim them as tax dependents.
Non-dependent child under 26 Sometimes Include them only if you want to cover them on your Marketplace plan.
Children under 21 you take care of Yes Include any child under 21 you take care of and who lives with you, even if not your tax dependent.
Unborn children No Don’t include a baby until it’s born. You have up to 60 days after the birth to enroll your baby.
Non-dependent child or other relative living with you No Include them only if you’ll claim them as tax dependents.
Dependent parents Yes Include parents only if you’ll claim them as tax dependents.
Dependent siblings and other relatives Yes Include them only if you’ll claim them as tax dependents.
Spouse Yes Include your legally married spouse, whether opposite sex or same sexIn most cases, married couples must file taxes jointly to qualify for savings.
Legally separated spouse No Don’t include a legally separated spouse, even if you live together.
Divorced spouse No Don’t include a former spouse, even if you live together.
Spouse, living apart Yes Include your spouse unless you’re legally separated or divorced. (See next row for an important exception.)
Spouse, if you’re a victim of domestic abuse, domestic violence, or spousal abandonment Not required In these cases, you don’t have to include your spouse. See rules for victims of domestic abuse, domestic violence, or spousal abandonment.
Unmarried domestic partner Sometimes Include an unmarried domestic partner only if you have a child together or you’ll claim your partner as a tax dependent.
Roommate No Don’t include people you just live with — unless they’re a spouse, tax dependent, or covered by another exception in this chart.

More answers: Who to include i

Citations

  1. Who to Include in Your Household. HealthCare.Gov.