Pennsylvania Code
Title 55 - HUMAN SERVICES
Part II - Public Assistance Manual
Subpart C - Eligibility Requirements
Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS
Subchapter B - ELIGIBILITY PROVISIONS FOR THE HEALTHY HORIZONS PROGRAM FOR THE ELDERLY/DISABLED
BENEFIT COVERAGE
Section 140.331 - Benefit coverage

(a) The Department will provide the following under the Healthy Horizons Categorically Needy Program:

(b) The Department will provide the following under the QMB Healthy Horizons Medicare Cost-Sharing Program:

(c) Under the Healthy Horizons SLMB Medicare Cost-Sharing Program, the Department will provide buy-in of only the Medicare Part B premium if the individual is enrolled in or eligible for Medicare Part A.

(d) For QI-1s, to the extent that Federal funding is provided, the Department will provide full Medicaid payment of the Medicare Part B Premium if the individual is enrolled in or eliglble for Medicare Part A.

(e) For QI-2s, to the extent that Federal funding is provided, the Department will provide partial Medicaid payment of the Medicare Part B Premium if the individual is enrolled in or eligible for Medicare Part A. This is a reimbursement to the recipient, not a premium payment to Medicare.

(f) For QI-2s, partial payments of Medicare Part B premium payment will be made for the calendar year. For all other recipients of payments, the Department will pay the Medicare Part A premium, if appropriate, and the Medicare Part B premium beginning with the month following the month in which the applicant is determined eligible.