Federal changes include cost of living adjustments (COLAs) and other mass changes to the following benefits:
Social Security (Retirement, Survivor's and Disability Insurance (RSDI), including the deduction for Medicare
Note: If an increase in Social Security benefits makes an individual ineligible for SSI, the CAO will decide on eligibility for extended coverage under the Pickle Amendment. (See Chapter 387, Supplemental Security Income.)
Veterans Administration (VA) benefits.
Black Lung benefits.
Railroad Retirement benefits.
Other federal benefits.
When there is a change in income, including a COLA or other mass change in federal benefits, the individual will report the change by the tenth day of the month after the change. The individual does not have to verify the change unless the CAO is unable to confirm it. The CAO will first check various reporting systems before requiring the individual to verify any changes that are reported. 55 Pa. Code ยง 133.84 (d)
Exception: This does not apply to individuals living in a long-term care facility. For those individuals, a change in income will be reported within ten days of when the income is received.
DPW will let the CAO know the effective date of a benefit increase that is federally funded and how it will be carried out. When information is provided in advance, the CAO will complete a case review to decide what effect the increased income will have on eligibility for MA. The review will be completed within five days of the expected change. A new PA 600 form does not need to be filled out. See Appendix A for information about the current COLA procedure
Note: The COLA adjustment is not applied to Healthy Horizons categorically needy and Medicare cost-sharing recipients (including long-term care individuals in Buy-In) when deciding on income eligibility for MA until after the federal poverty income guidelines (FPIGs) are issued. The MA eligibility review of these cases cannot be completed until after the annual update of the FPIGs is received. Normally, the FPIGs are published in January of each year, which means the COLA income will not be applied until March. This applies only to Healthy Horizons recipients. The CAO will complete a review in March using the updated income and FPIGs.
The CAO will confirm mass changes in RSDI and SSI benefits through BENDEX, the State Data Exchange (SDX), or the Income Eligibility Verification System (IEVS).
Railroad Retirement, Veterans Administration, and Black Lung information is not available through system matches. Individuals who receive these benefits may or may not get the COLA. The individual will report the increase and verify the new amount.
Updated February 14, 2012, Replacing October 17, 2008