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
VERIFICATION REQUIREMENTS
Section 140.311 - Verification requirements
Universal Citation: 55 PA Code ยง 140.311
Current through Register Vol. 54, No. 44, November 2, 2024
(a) Verification requirements under Healthy Horizons are as follows:
(1)
Verification of income.
Verification of income is required prior to the authorization of Healthy
Horizons benefits. However, an applicant/recipient may not be denied MA under
the Healthy Horizons Program for lack of verification if the
applicant/recipient has cooperated in the verification attempt under Chapter
125 (relating to the application process) and §
133.73 (relating to
requirements).
(2)
Verification of resources. Verification of ownership, the
value of resources and the disposition of resources is required of an
applicant/recipient or the person acting on behalf of the applicant/recipient
including guardians and trustees under §
178.3 (relating to resource
reporting and verification for all categories of MA).
(3)
Verification of qualified
Medicare beneficiary status. The Medicare Part A Card is considered
verification of qualified Medicare beneficiary status.
(b) Under the Healthy Horizons Categorically Needy Program, the following verification is also required:
(1)
Verification of age.
(i) Documentation verifying the date of birth
for persons 65 years of age or older is required. Benefits may be authorized if
the stated date of birth appears to be reasonable. The applicant/recipient is
required to provide verification of age within 30 days from the date of
authorization.
(ii) Documentation
of date of birth is not required if previously verified and properly notated in
the case record unless a discrepancy exists.
(2)
Verification of
disability.
(i) Recipient of Social
Security Disability Benefits or disability benefits based on SSI disability
criteria is considered verification of disability.
(ii) If the applicant is not receiving
disability benefits, the following shall be submitted:
(A) Medical verification of a disability
which meets the SSI disability criteria.
(B) Proof that the person has applied for
disability benefits and is awaiting a decision.
Disclaimer: These regulations may not be the most recent version. Pennsylvania may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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