Pennsylvania Code
Title 55 - HUMAN SERVICES
Part II - Public Assistance Manual
Subpart C - Eligibility Requirements
Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS
Subchapter D - ELIGIBILITY PROVISIONS UNDER THE MEDICAID FOR CHILDREN WITH SPECIAL NEEDS CATEGORY
GENERAL ELIGIBILITY PROVISIONS
Section 140.603 - Conditions of MA eligibility

Universal Citation: 55 PA Code ยง 140.603

Current through Register Vol. 54, No. 44, November 2, 2024

(a) An applicant or recipient shall meet the eligibility provisions of Subchapter B (relating to eligibility provisions for the healthy horizons program for the elderly/disabled) except the following types of income are not counted:

(1) Court-ordered child support.

(2) Retirement, Survivor's, Disability Insurance (RSDI) benefits received from the Social Security Administration by the applicant or recipient.

(b) The applicant or recipient shall meet the following eligibility provisions:

(1) Chapter 125 (relating to application process).

(2) Chapter 148 (relating to MA residence provisions for categorically needy NMP-MA and MNO-MA).

(3) Chapter 150 (relating to citizenship and alienage provisions for categorically needy NMP-MA and MNO-MA).

(4) Chapter 155 (relating to enumeration).

(5) Chapter 255 (relating to restitution).

(c) The custodial parent shall report and verify earned and unearned income and allowable medical and dental expense deductions specified in § 140.604(b) (relating to premiums).

(1) The verification of income is limited to the custodial parent's Federal Income Tax Return listing the reported adjusted gross income of the previous calendar year.

(2) The verification of allowable medical and dental expenses is limited to those medical and dental expenses that were not reimbursed and that the custodial parent deducted on the Federal Income Tax Return of the previous calendar year.

(3) If the Federal Income Tax Return of the previous calendar year is not available or there is a decrease in income from the previous calendar year, any of the following items may be used to verify current income:
(i) Pay stubs.

(ii) Pay envelopes.

(iii) Statement by the employer.

(iv) Other documentary proof of the income of the custodial parent.

(d) An applicant or recipient is ineligible for MA if the custodial parent does not report or verify earned or unearned income.

This section cited in 55 Pa. Code § 140.604 (relating to premiums).

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