The following people may be added to an EMC budget group: 55 Pa. Code § 140.514
Newborns
A spouse, parent, TANF-qualified child or essential individual who was in the budget group when the TANF or TANF-related NMP-F budget was closed but had left and now has come back
A spouse, parent, TANF-qualified child or essential individual whose needs and income would be considered in deciding TANF or TANF-related NMP-F eligibility if the family were applying in the current month
NOTE: This includes individuals who did not live in the home when TANF or TANF-related NMP was closed but moved into the home during the EMC period.
If the CAO learns during a nonreview period that a individual has left the household, the individual must be removed from the budget group. The CAO will let the budget group know that the individual is no longer counted. 55 Pa. Code § 140.515
If the individual who left was the only child, the CAO will stop EMC for the entire budget group with proper notice, and decide on MA eligibility for the remaining members in other categories. 55 Pa. Code § 140.401
If the individual who left was a specified relative and there are no TANF qualified children living with the specified relative, the CAO will stop EMC with proper notice.
If a child’s age is over the TANF age rule and there are other children in the budget group, the CAO must remove the child in the month following the month of the child's birthday, with proper notice. 55 Pa. Code § 140.515(3)
NOTE: Before the effective date, the CAO will look at the child’s eligibility for other MA categories and, if the child is eligible, continue MA.
Example: Mrs. Clark and her children ages 10, 11, and 17 are approved for EMC in May. The oldest child, Paul, graduates in June and turns 18 in June. Paul is removed from the EMC budget as of July (the month following the month he no longer meets the TANF age rule). The CAO will decide whether Paul is eligible for other MA categories, including NMP coverage in the PC category.
If an employed specified relative has separated from his or her spouse, the CAO will take the following actions:
Split the budget group into two or more budget groups.
Decide on the continuing eligibility of each new budget group.
If a budget group remains eligible but does not include the individual in whose name the payment was made, create a new case record and continue EMC. The begin date for this new budget group is the day after the TANF or TANF-related NMP-F budget closes.
Updated February 14, 2012, Replacing March 28, 2008