55 Pa. Code § 181.1 - General policy on MA income common to all categories of MA
(a) In determining income eligibility for
categorically needy NMP-MA, the total amount of income available to the
applicants/recipients in 1 calendar month is used.
(b) In determining income eligibility for
MNO-MA, the total amount of income available to the applicants/recipients in a
consecutive 6-calendar month period is used. In determining income eligibility
for retroactive eligibility coverage for MNO-MA, the total amount of income
available to the applicants/recipients in the combined retroactive and
prospective period, a consecutive 6-calendar month period, is used. The
combined period can be less than 6 months only if the applicant/recipient is
deceased.
(c) A person receiving
AFDC, GA, SBP or SSI and who is living in the household of a person applying
for, or receiving, MA is not included in the determination of MA eligibility.
The income of persons living in the household is not considered available to
meet the needs of a person applying for, or receiving, MA except for payments
made to the applicant/recipient for goods, services, rent, room and
board.
(d) As a condition of
eligibility for MA, an applicant/recipient shall take necessary steps to obtain
and make available potential sources of income available to him, such as, but
not limited to, benefits under retirement, unemployment compensation, workers
compensation, State or county retirement and disability benefits, veterans
benefits, union pensions and employer's pensions and annuities.
(1) An applicant, except a PD or TD
applicant-see §§
181.41 and
181.42 (relating to categories of
NMP-MA; and categories of MNO-MA)-or a recipient who, without good cause, fails
to cooperate in an effort to establish eligibility for SSI, Retirement,
Survivors and Disability Insurance (RSDI), or another potential benefit is
ineligible for MA until the applicant complies with the cooperation
requirement.
(2) A PD or TD
applicant-see §§
181.41 and
181.42 -who, without good cause,
fails to cooperate in establishing eligibility for a potential benefit is
ineligible for MA for a minimum of 60 calendar days. Ineligibility for MA
continues after the minimum of 60 calendar days until the applicant complies
with the cooperation requirement.
(e) In determining income eligibility for MA
for an applicant/recipient group in an AFDC- or GA-related category which
includes a woman whose pregnancy is verified, the unborn child is counted as a
member of the applicant/recipient group. If multiple births are expected and
verified, each unborn child is counted as a member of the applicant/recipient
group.
(f) In determining income
eligibility for MA, the amounts in Appendices A-J are used as specified in this
chapter. Revisions that are required by Federal law or regulations to the
appendices will be published as a notice in the Pennsylvania
Bulletin, for codification in the Pennsylvania Code.
(1) Appendix A is the Federal benefit rate
plus the State supplement payable under Title XVI of the Social Security Act
(42 U.S.C.A. §§
1381-1383c).
(2) Appendix B is 300% of the Federal benefit
rate payable under Title XVI of the Social Security Act.
(3) Appendix C is the family size allowance,
by county and family size, payable under the State's AFDC Program under Title
IV-A of the Social Security Act (42 U.S.C.A. §§
602-615).
(4) Appendix D is the Federal benefit rate
payable under Title XVI of the Social Security Act.
(i) Item 1 is one-half of the Federal benefit
rate payable under Title XVI of the Social Security Act for one
person.
(ii) Item 2 is one-half of
the Federal benefit rate payable under Title XVI of the Social Security Act for
two persons.
(5) Appendix
E is a chart of calculations of one-third of the family size allowance payable
under the State's AFDC Program under Title IV-A of the Social Security
Act.
(6) Appendix F is the State's
medically needy income limit determined under 42 CFR 435.812 (relating to
medically needy income standards: reasonableness), subject to the limitations
in 42 CFR
435.1007 (relating to medically
needy).
(7) Appendix G is the
monthly figures for the medically needy income limit.
(8) Appendix H is one-third of the monthly
income amount for medically needy only income eligibility.
(9) Appendix I is the standard of need of the
State's AFDC Program under Title IV-A of the Social Security Act.
(10) Appendix J is the gross income limit for
AFDC- and GA-related NMP-MA cases, based on the gross income test in the
State's AFDC Program under Title IV-A of the Social Security
Act.
Notes
The provisions of this § 181.1 amended under sections 201(2) and 403(a) of the Public Welfare Code (62 P. S. §§ 201(2) and 403(a)).
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.