Eligibility for MNO is based on the net income available to the applicant/recipient group after allowable deductions in the combined retroactive/continuing period. This income eligibility period is six calendar months in a row. Figuring out eligibility for MNO begins with the applicant/recipient group's gross income. (See Chapter 350, Income), for information on what income is counted for MNO.) 55 Pa. Code § 181.1(b) 62 P.S. § 442.1(c)
Note: If cash assistance benefits will be received, the income must be included as unearned income in the combined retroactive/continuing period.
For retroactive months, the CAO must decide how much income was available to the applicant/recipient group for each month in the six-month eligibility period. The eligibility period starts the first day of the first month the individual has a medical need. The income for each month in the six-month period will either be:
The actual income for the month.
If the income is received once a week or once every two weeks, the weekly average income multiplied by four.
The CAO will use an averaged weekly amount to estimate the income for the rest of the six-month eligibility period if the income will stay the same. If the income will change during the six-month period, the caseworker must figure out each month’s income.
For continuing months, the CAO will use averaged income that will be available to the applicant/recipient group for a six-month period if the income will stay the same. To estimate future income, the CAO will take the following actions: 55 Pa. Code § 181.11(c)
Find out whether income is received monthly, semimonthly, weekly, biweekly, or some other way.
Find out whether the income is expected to continue through the six-month period.
Count only income that is expected to be received within the six-month period.
For income that is received weekly or biweekly, figure out the average weekly pay and multiply it by 4 to receive the average monthly pay.
If needed, figure out the amount separately for each month.
Examples:
On September 3, Mr. and Mrs. Bennett apply for MNO for themselves and their two children, ages 5 and 7. Mr. Bennett earns $400 a week, and Mrs. Bennett earns $100 a week. Mrs. Bennett has a hospital bill of $3,000 from July 24. She did not miss any paychecks in July.
Gross income computation
Mr. Bennett, July–December (400 × 4) |
$1,600 |
Mrs. Bennett July–December (100 × 4) |
$400 |
Note: Because Mr. Bennett and Mrs. Bennett each receive five paychecks in September and December, the CAO multiplies the weekly income by 4 to receive the monthly amount.
Mr. Young applies on October 12 and has a medical bill of $12,000 for August 20 to September 3. He worked in August until he had an accident. He returned to work part-time on September 8 and full-time on September 18. He works 30 hours a week and received $180 a week. The following are his pay amounts for August, September, and October:
8/4, 8/11 and 8/19 |
$180 a week |
8/26, 9/2 and 9/9 |
No pay |
9/16 |
$90 |
9/23 and 9/30 |
$180 a week |
10/7 and after |
$180 a week |
Gross income computation
Aug. ($180 × 3) |
$540 |
Sept. ($90 + ($180 × 2)) |
$450 |
Oct., Nov., Dec., and Jan. ($180 × 4) |
$720 |
Note: Even though December is a five-paycheck month, the four-paycheck income-averaging process is used.
The CAO will average the income of an individual who is employed under a job contract that runs for a year if the income is received in less than twelve months but more than eight months. The CAO will prorate the income over the time of the contract. If the income is received during a period of less than eight months, the CAO will count the income actually received or expected to be received during the period of eligibility. 55 Pa. Code § 181.22
Updated February 14, 2012, Replacing November 3, 2008