Calculate Income Without a Tax Return

Use this form if any of these apply:

You DID NOT file a tax return last year
You work part-time or seasonally
You expect a change in your household size this year (such as marriage, divorce, or a birth or adoption)
You expect a change in income, such as loss or gain of a job, or retirement

This form will calculate your Modified Adjusted Gross Income (MAGI). You will need this number when you apply.
Enter annual amounts below. Include amounts for a spouse if you are married filing jointly for the year or for any dependents who make or expect to make taxable income.

Enter your gross wages/salary/tips (before taxes are taken out)
Be sure to include any overtime, bonus, or severance pay. Please note that pre-tax contributions to dependent care accounts, health insurance premiums, flexible spending accounts, retirement accounts and commuter expenses are NOT included as income.
Enter your self-employment (profit once business expenses are paid)
See IRS Schedule C.
Enter your Social Security benefits (including both taxable and non-taxable)
Social Security Disability Insurance (SSDI) is included here. Social Security Income (SSI) income is not included here. If you are receiving SSI, you are automatically eligible for Medicaid in the state of Maryland. Do not include any veterans disability benefits you may receive.
Enter the total of any unemployment benefits you receive or expect to receive this year
Enter your retirement benefits (taxable IRA distributions, pensions, and annuities)
Enter your interest (including tax-exempt interest)
Enter your net capital gains (profit after subtracting capital losses)
Enter your dividends
Enter your rental or royalty income (profit after subtracting costs)
Enter other taxable income, such as canceled debts, court awards, jury duty pay not given to an employer, cash support, and gambling, prizes, or awards or farm income. Also include taxable refunds, credits or offsets of local or state income taxes.
Enter your foreign earned income
Deductions
Now enter the annual amounts for these deductions below:
Enter any deductible interest from student loans you (or a qualifying dependent) have or will have this year
Households may be able to deduct a portion of the interest they expect to pay on a qualified student loan. Box 1 of the 1098-E Form shows the interest paid for the prior year, which may be helpful in projecting student loan interest that will be paid during the year. Note: IRS deduction limits may be applied to the amounts you entered. The maximum amount you may include for this deduction is $2,500 annually.
Enter your IRA deduction
IRS deduction limits may be applied to the amounts you entered. The maximum amount you may include for this deduction is $6,500 annually.
Enter the deductible portion of tuition and fees for yourself or qualifying dependents
The maximum deductible allowed is $2,000 or $4,000 depending on income. For additional information, see IRS publication 970.
Enter your health savings account contributions
Enter your penalties on the early withdrawal of savings
Enter your certain business expenses of performing artists, reservists, and fee-basis government officials
Military households only: enter any deductible moving expenses you or your spouse had or expect to have related to a job change.
Certain time and distance requirements must be met to qualify for this deduction. For more information, see IRS Publication 521.
Enter your Domestic Production (Farming/Fishing) Activities deduction
Enter the amount of your capital loss
Note: IRS deduction limits may be applied to the amounts you entered. The maximum amount you may include for this deduction is $3,000 annually.
Your Modified Adjusted Gross Income (MAGI) is:
Use this income amount when you apply for health coverage through Maryland Health Connection.

Calculate Income Without a Tax Return

Calculate Income Without a Tax Return

Calculate Income Without a Tax Return

Calculate Income Without a Tax Return

Deductions

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