350.6 Income Exclusions

The CAO will not count certain income when determining eligibility for MA.

The CAO will verify and record why certain income is excluded. The CAO may also need to verify the amount of the excluded income.

350.61 Excluded Income—MAGI-Related, TANF-Related, GA-Related, and SSI-Related

The following income is excluded for TANF-related, GA-related, and SSI-related categories of MA:

 55 Pa. Code § 181.81(2)     

 55 Pa. Code § 178.4(g)

Income tax refunds received after December 31, 2009 are excluded as income or a resource for 12 months.

This includes the entire refund – refundable credit, Earned Income Tax Credit (EITC) and excess withholding.

If any part of the refund remains after the 12 months period, it must be counted as a resource.

 

55 Pa. Code § 181.81(8)      

55 Pa. Code § 181.263(2)

DHS pays recipients back for excess copayments for MA services made by a recipient in a six-month period. The CAO will not count these refunds as income.

 

55 Pa. Code § 181.121(8)      

55 Pa. Code § 181.264(8)

The CAO will not count money that an individual receives from the WIA Agency (formerly the Job Training Partnership Act) for specific needs or support services, such as child care, transportation, or meals.

 

 55 Pa. Code § 181.121(7)    

55 Pa. Code § 181.264(7)

The CAO will not count money that an individual receives under Title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970.

 

55 Pa. Code § 181.123(13)      

55 Pa. Code § 181.264(13)

The CAO will not count money that an individual receives under the Senior Citizen Rebate and Assistance Act, such as property tax refunds and rent rebates.

 

 55 Pa. Code § 181.123(9)     

 55 Pa. Code § 181.264(15)

The CAO will not count money paid by a public or private placement or child care agency to the individual for providing foster care for a child. Money that an individual receives through Title IV-E of the Social Security Act or Article VII of the Public Welfare Code is restricted to meet the needs of the foster child.

The CAO will not count maintenance subsidies that an individual receives under the Adoption Opportunities Act.

 

55 Pa. Code § 181.121(3)       

55 Pa. Code § 181.264(3)

The CAO will not count the value of supplemental food assistance that an individual receives from the Women, Infants, and Children (WIC) program or the National School Lunch Act.

 

 55 Pa. Code § 181.121(1)      

55 Pa. Code § 181.264(1)

The CAO will not count the value of SNAP benefits that an individual receives.

 

55 Pa. Code § 181.121(2)        

55 Pa. Code § 181.264(2)

 

The CAO will not count the value of food donated by the United States Department of Agriculture.

 

 55 Pa. Code § 181.123(3)        

55 Pa. Code § 181.263(9)

The CAO will not count the value of fruits or vegetables grown at home if an applicant/recipient group eats it themselves.

 

55 Pa. Code § 181.121(6)       

 55 Pa. Code § 181.264(6)

The CAO will not count Section 8 housing or utility subsidies, rehabilitation grants, or other federal housing subsidies that an individual receives under the U.S. Housing Act of 1937, the National Housing Act, Section 101 of the Housing and Urban Development Act of 1965, Title V of the Housing Act of 1949, or the Housing and Community Development Act of 1974.

 

55 Pa. Code § 181.121(5)      

55 Pa. Code § 181.264(4)       

The CAO will not count benefits that an individual receives for home energy assistance under LIHEAP.

 

55 Pa. Code § 181.81(7)   

 55 Pa. Code § 181.264(17)

The CAO will not count weatherization services or assistance payments.

 

55 Pa. Code § 181.123(11)     

 55 Pa. Code § 181.264(17)

The CAO will not count home energy assistance (HEA) benefits. These benefits are provided in-kind by a private, nonprofit organization or as cash or in-kind assistance by:

HEA benefits may include payments for heating or cooling, storm doors, weatherization services, blankets, and the like. HEA benefits do not include food or clothing.

NOTE: If the CAO cannot determine whether a vendor is certified or an agency is registered with the DHS, they will contact the area manager. If the vendor or agency is not registered, the CAO will count the HEA benefit as unearned income.

   

55 Pa. Code § 181.123(11)       

55 Pa. Code § 181.264(18)   

The CAO will not count in-kind support or maintenance assistance benefits provided by a private, nonprofit agency. SMA benefits include food, clothing, temporary emergency shelter, furniture, appliances, and the like.

 

55 Pa. Code § 181.121(15)     

55 Pa. Code § 181.264(11)  

 

The CAO will not count payments made:

NOTE:  Money from an AmeriCorps State and National program or the AmeriCorps National Civilian Community Corps (NCCC) program must be counted.

 

55 Pa. Code § 181.81(10)       

55 Pa. Code § 181.263(8)  

 

The CAO will not count money that an individual borrows.

Exception: For TANF/GA-related categories, money loaned by an LRR must be counted as support.

NOTE:   Reverse mortgage payments (whether lump sum, monthly installment, or a combination of both) are considered loans in the month they are received. There is no exclusion for the resource if money from the loan is kept after the month in which the individual receives it.

 

55 Pa. Code § 181.81(1)   

55 Pa. Code § 178.1(i)     

The CAO will not count money that an individual receives from converting a resource to cash. This includes any cash or in-kind item that is given to replace or repair an item that was lost, damaged, or stolen. The money will be counted as a resource.

 

55 Pa. Code § 181.81(12)       

55 Pa. Code § 181.263(6)

The CAO will not count payments made under the Department of Aging's Family Caregiver Support Program. These payments are made to pay the individual back for the following:

55 Pa. Code § 181.121(18)    

 55 Pa. Code § 181.264(19)

The CAO will not count payments made under Title I of the Civil Liberties Act of 1988 or Title II of the Aleutian and Pribilof Island Act enacted August 10, 1988, including payments made to survivors of Japanese Americans.

This exclusion continues as long as the payments are kept separate and identifiable. If the payment is used to purchase real property or personal property, the CAO will count the new resource, unless it is excluded. Interest on the payments is counted unless it is excluded under another rule.

 

 

The CAO will not count payments from settlements against companies making blood products in Walker v. Bayer or In re FACTOR VIII or IX Concentrate Blood Products Litigation or from the Ricky Ray Hemophilia Relief Fund. (If the payment comes from a different settlement, then the CAO should contact the Policy Clarification Unit for instruction on how to verify that the payment falls under an exempt hemophiliac class action settlement payment.) Any interest earned on these accounts will be counted as income.

 

 

The CAO will not count income paid to an individual as a difficulty-of-care payment. A difficulty of care payment is money paid to a non relative or parent who is under contract with a public or private agency to give care to a person with a mental disability in his or her home. These payments come under other program titles, including the following:

NOTE:  A Family Living Services payment may come as one payment or as two payments (one for services and one for room and board)

.

 

Passed on August 1, 1994, the Nazi Persecution Victims Eligibility Act (P.L. 103-286) excludes from income and resources any payments made to persons who were victims of Nazi persecution. This original provision supersedes previous provisions for the exclusion of certain payments made by the governments of Germany, Austria, and The Netherlands insofar as they are made to victims of Nazi persecution (New one indicates that only payments made by those three countries are excluded). Any interest earned on these accounts will be counted as income.

 

 

All funds in SEED accounts, including interest, are excluded as income and resources. SEED accounts are accounts set up for children born on or after January 1, 2006. These accounts are currently only active in the Philadelphia area. SEED accounts:

 

350.62 Excluded Income—TANF-Related

In addition to the income listed in Section 350.61, the following income is excluded for TANF-related categories only:

 

The CAO will not count any money an individual receives from signing a DHS reimbursement form.

55 Pa. Code § 181.263(1)

55 Pa. Code § 181.263(3)

The CAO will not count any money an individual receives to correct underpayments in the month when the individual receives it or in the next month.

NOTE:  Any money left over from the payment will be considered a resource in later months.

 

55 Pa. Code § 181.263(4)

The CAO will not count any retroactive assistance payments an individual receives as a result of a pre hearing conference, fair hearing decision, or court order.

NOTE:  A retroactive payment is excluded only for the month in which the individual receives it and the following month. Any money left after the second month is treated as a resource.  The individual must show proof of how and when the money is used.

 

55 Pa. Code § 181.263(5)

The CAO will not count support payments refunded to the individual when the monthly cash assistance payment is suspended for one month because of:

 

 55 Pa. Code § 181.264(16)

 

For TANF-related MA, the CAO will give one support disregard.  The disregard is one of:

The budget group receives only one support disregard. If the budget group receives both spousal and child support, the CAO will apply the support disregard that will most benefit the budget group.

NOTE:  Disregard does not apply to past-due support payments. Money paid to cover past-due support payments is considered a lump sum payment. (See Chapter 357, Lump Sum).

 

55 Pa. Code § 181.263(6)

The CAO will not count money, goods or services an individual receives from a public or private agency.

 

 55 Pa. Code § 181.263(7)  

The CAO will not count in-kind goods or services given by an individual to an applicant/recipient group or third-party payments made to a vendor for the applicant/recipient group.

 

55 Pa. Code § 181.264(12)       

The CAO will not count benefits that an individual receives under Part C of the Congregate Nutrition Service of the Older Americans Act of 1965.

 

 55 Pa. Code § 181.263(10)

The CAO will not count money that an individual receives from providing day care for children in an approved family day care home.

Exception: This exemption does not apply to employees of the approved family day care home.

 

55 Pa. Code § 181.264(9)

The CAO will not count money that an individual receives under the Alaska Native Claims Settlement Act.

 

  55 Pa. Code § 181.264(10)

The CAO will not count the following payments to Indian tribes:

(Pub L. 93-134)

 

55 Pa. Code § 181.263(8)      

The CAO will not count loans, such as, but not limited to, car loans or personal loans, from individuals who are not LRRs. Gifts of $50 or less for each individual in a calendar quarter will not be counted, no matter whether the giver is or is not an LRR.

A gift that a member of an applicant/recipient group receives may be divided among all the members in the group if the gift is meant for the whole group.

If gifts add up to more than $50 for each individual in a calendar quarter, the amount of the gifts over $50 for each individual will be treated as a resource in the month it was received.

 

55 Pa. Code § 181.262

The CAO will not count student financial assistance from loans, grants, scholarships, or work-study.

 

42 U.S.C. Section 5515(d)

The CAO will not count disaster unemployment assistance as income or a resource.              

62 P.S. 432.12

 

350.63 Excluded Income—SSI-Related

In addition to the income listed in Section 350.61, the following income is excluded for SSI-related categories only:

 

55 Pa. Code § 181.121(11)

The CAO will not count tax-exempt payments that an individual receives under Section 21(a) of the Alaska Native Claims Settlement Act.

The CAO will not count money that an individual receives under a program set up before July 1, 1973, that provides payments on the sole basis of how long someone has lived in Alaska and that individual has reached age 65. The Alaska Longevity Bonus is excluded under Section 1612(b)(2)(B) of the Social Security Act.          

 55 Pa. Code § 181.121(12)

 

The CAO will not count the following:         

55 Pa. Code § 181.121(13)

Pub L. 92-254  

Pub L. 94-540   

Pub L. 95-433

Pub L. 93-134

Pub L. 94-114          

55 Pa. Code § 181.121(14)

     

55 Pa. Code § 181.121(16)

The CAO will not count any money, other than wages, that an individual receives under the Older Americans Act of 1965.

 

55 Pa. Code § 181.121(17)

The CAO will not count retroactive SSI or RSDI payment for six calendar months after the month when the individual received the payment.

NOTE:  If part of the payment remains after the end of the six-month period, it is counted as a resource.

 

55 Pa. Code § 181.122     

The CAO will not count earned income less than $10 that is:.

Example: Mrs. Nguyen does housecleaning on a regular basis and earns $80 a week. On November 20, a customer pays her $10 for some extra cleaning. On December 22, the same customer asks for extra cleaning and pays her $10. The CAO does not count the $10 Mrs. Nguyen received on November 20. They count the $10 she received on December 22, because she received the earned income more than once in a quarter.

 

55 Pa. Code § 181.123(4)

The CAO will not count, for 18 months, money that an individual receives because of a situation that is declared a major disaster by the President under the Disaster Relief Act of 1974 or another federal law. All of the following conditions must be met:

The income exclusion begins on the date the individual received the disaster assistance and ends on the last day of the18th full month after that.

The CAO will take the following actions:

Example: Because of a flood on September 10, 2009, which was declared a disaster by the President, Mr. Burke receives unemployment compensation under the Disaster Relief Act of 1974. He receives $60 a week, starting on October 1. The CAO excludes the income from October 1, 2009 through March 31, 2011.

 

55 Pa. Code § 181.123(5)   

The CAO will not count interest earned on disaster relief assistance from the time the individual received it through the last day of the ninth full month after that.

The CAO will extend this period to 18 full months if the individual shows good cause for not repairing or replacing the property for which the disaster relief was given. Good cause includes any situation beyond the individual’s control that prevents the repair or replacement of a home or other property within the nine-month period.

The individual must show proof from at least two contractors that they made a reasonable effort to have the damaged property repaired or replaced within the first nine-month period. If the disaster resulted in a lot of work needed in the area, the CAO may contact area contractors to determine the minimum time needed to complete the work. An extension is granted only if the individual says that they still plan to make the repairs. The CAO will keep all written documentation in the record and record any information received during person-to-person contact.

The CAO will take the following actions:

 

55 Pa. Code § 181.123(7)

The CAO will not count unearned income that is less than $20 a month and is received too rarely to be expected on a regular basis. If the amount is more than $20 or is received more than once in a calendar quarter, the full amount will be counted as income.

Example: Mrs. Arnold wins $18.50 in the lottery on February 10, $20 on March 15, and $19.30 on May 20. The CAO excludes the February 10 winnings, because the total was less than $20. The CAO counts the March 15 payment, because Mrs. Arnold received money from the lottery more than once in a quarter. The CAO excludes the May 20 payment because it was less than $20.

 

55 Pa. Code § 181.123(8)     

The CAO will not count periodic payments made by a state on the sole basis of how long someone has lived in the state and that individual has reached age 65, under a program established before July 1, 1973.

 

55 Pa. Code § 181.123(10)

The CAO will not count interest earned on a burial fund that has been excluded as a resource, if the interest builds up as part of the burial fund. (See Chapter 340, Resources.)

NOTE:  If the interest is withdrawn, the CAO will count it as income.

 

55 Pa. Code § 181.123(14)

If unearned income is reduced to pay back an overpayment, the CAO will count the individual’s net income if the overpaid amount was counted when determining the individual’s eligibility for cash assistance or MA when the overpayment occurred.

The CAO will take the following actions:

 

55 Pa. Code § 181.123(15)

The CAO will not count a lump sum advance payment made to cover money spent to get income.

 

 55 Pa. Code § 181.81(3)

The CAO will not count payments made under a credit life or disability insurance policy issued to, or on behalf of, borrowers to cover payments on loans or installment purchases if an individual dies or becomes disabled. These payments are made directly to the loan or mortgage company and are not available to the individual.

 

55 Pa. Code § 181.81(4)  

The CAO will not count money that an individual receives from another person as repayment of a loan.

NOTE:  Interest earned on the money loaned will be counted as income.

 

55 Pa. Code § 181.81(5)  

The CAO will not count any payment on a bill made for an individual by a third party.

 

55 Pa. Code § 181.81(6)  

The CAO will not count money that an individual receives to replace income that was lost, stolen, or destroyed.

Example: An individual’s paycheck is stolen before they are able to cash it, and the employer issues a replacement check. The CAO counts the original paycheck as earned income in the month of receipt and excludes the replacement check.

 

 55 Pa. Code § 181.81(9)

The CAO will not count the portion of the VA benefit that is an Aid and Attendance or Housebound allowance. (For information on verifying Aid and Attendance benefits, see Chapter 378, Verification, Appendix B.)

NOTE: Any part of the Aid and Attendance benefit that is left after the month the individual received it is counted as a resource.

 

55 Pa. Code § 181.81(12)

The CAO will not count any of the following:

 

55 Pa. Code § 181.81(14)

The CAO will not count money given as assistance to a homeless individual.

 

55 Pa. Code § 181.121(4)

The CAO will not count money that an individual receives under the Energy Emergency Crisis Assistance Program or the Emergency Energy Conservation Services program under Section 222(a)(5) of the Economic Opportunity Act of 1964.

 

55 Pa. Code § 181.123(1)

The CAO will not count money that an individual receives from a public agency as a refund of taxes paid on real property.

 

 55 Pa. Code § 181.81(11)     

The CAO will not count medical care and services that are:

Example: The CAO will not count money paid to an individual from an insurance company to pay the individual back for payments for prescription drugs.

 

55 Pa. Code § 181.81(13)           

The CAO will not count noncash items that are excluded as MA resources.

 

55 Pa. Code § 181.134

The CAO will not count the amount spent by the individual on court-ordered guardian fees if having a guardian is a condition of receiving the income.

 

55 Pa. Code § 140.271(20)

The CAO will not count interest earned on agreements for the purchase of excluded burial spaces if the interest is left to build up. Interest not left to build up is counted as income.

 

 

The CAO will not count income from an account in a financial institution that is set up only to receive and maintain SSI past-due benefits. Any interest or other earnings on such an account is excluded from resources.

 

 

The CAO will not count payments from interest or other earnings from a dedicated financial institution account that is excluded from resources.

 

The CAO will not count the monthly fee paid to an agency that is approved by the SSA to receive the individual’s monthly RSDI or SSI benefit or state supplementary payment. The excluded amount must be 10% of the monthly benefit or $37 a month, whichever is less.  If the individual has been determined by SSA to have a drug and alcohol condition, the excluded amount must be 10% of the monthly benefit, or $72 a month, whichever is less.

NOTE:  If the individual is in an institution, a fee may not be withheld from benefits that must be set aside for the individual’s personal needs.

 

 

The CAO will not count a one-time lump sum payment to an individual exposed to doses of radiation and found to have certain diseases after the exposure. Payment is made by the Federal Department of Justice to the individual or the individual’s survivors. Interest earned on the unspent payment is counted as income.

 

 

The CAO will not count payments made by any of the uniformed services under 37 U.S.C. 310.

 

 

The CAO will not count payments made to individuals in these volunteer services programs, including: Americorps VISTA, University Year of Action, Special and Demonstration Volunteer programs, the Retired Senior Volunteer Program (RSVP), the Foster Grandparent Program, and the Senior Companion Program.

 

 

The CAO will not count payments made to individuals who were captured and imprisoned or confined by North Vietnam.

 

 

The CAO will not count payments made to Vietnam veterans’ children who have spina bifida.

 

 

Effective May 1, 1991, the CAO will not count payments that an individual receives from a state-run victims compensation fund to cover expenses incurred or losses suffered as the result of a crime. Any money left after the calendar month when the individual receives the payment must also be excluded as a resource for nine more calendar months.

 

 

The CAO will not count a relocation assistance payment made by a state or local government in the month when the individual receives it. Any money left after the calendar month when the individual receives the payment is excluded as a resource for nine more calendar months.

 

55 Pa. Code § 181.121(9)      

 55 Pa. Code § 181.123(2)

The CAO will not count any financial assistance for educational expenses from scholarships, grants, and loans received by a child who is either under age 18 or under age 19 and a full-time student in secondary school or at the same level in a vocational or technical school. Any part of the financial assistance that is to be used only for basic living needs, such as housing and food, is not excluded.

NOTE:  For information about children age 19 to 21 who receive educational assistance, see Chapter 314, Students.

 

350.64 Excluded Income—GA-Related

In addition to the income listed in Section 350.61, the following income is excluded for GA-related categories:

 

55 Pa. Code § 181.263(1)

The CAO will not count any money an individual receives from signing a DHS reimbursement form.

 

 55 Pa. Code § 181.263(3)

The CAO will not count any money an individual receives to correct underpayments in the month when the individual receives it or in the next month.

NOTE:  Any money left over from the payment is considered a resource in later months.

 

55 Pa. Code § 181.263(4)

The CAO will not count any retroactive assistance payments an individual receives as a result of a prehearing conference, fair hearing decision, or court order.

NOTE:  A retroactive payment is excluded only for the month in which the individual receives it and the following month. Any money left after the second month is treated as a resource. The individual must show proof of how and when the money is used.

 

55 Pa. Code § 181.263(5)

The CAO will not count support payments refunded to the individual when the monthly cash assistance payment is suspended for one month because of:

 

55 Pa. Code § 181.263(6)

The CAO will not count money, goods, or services an individual receives from a public or private agency.

 

55 Pa. Code § 181.263(7)

The CAO will not count in-kind goods or services given by an individual to an applicant/recipient group or third-party payments made to a vendor for the applicant/recipient group.

 

55 Pa. Code § 181.264(12)

The CAO will not count benefits that an individual receives under Part C of the Congregate Nutrition Service of the Older Americans Act of 1965.

 

55 Pa. Code § 181.263(10)

The CAO will not count money that an individual receives from providing day care for children in an approved family day care home.

NOTE:  An approved family day care home is one in which child care is given at the same time to four, five, or six children who are not related to the operator. The home must have a certificate of registration issued by the DHS regional office of child day care stating that the home is an approved day care home.

Exception: This exemption does not apply to employees of the approved family day care home.

 

 55 Pa. Code § 181.264(9)

The CAO will not count money that an individual receives under the Alaska Native Claims Settlement Act.

 

55 Pa. Code § 181.264(10)

The CAO will not count the following payments to Indian tribes:

 (Pub L. 93-134)

 

55 Pa. Code § 181.263(5)

The CAO will not count loans, such as car loans or personal loans, from individuals who are not LRRs. Gifts of $50 or less for each individual in a calendar quarter will not be counted, no matter if the giver is or is not an LRR.

A gift that a member of an applicant/recipient group receives may be divided among all the members in the group if the gift is meant for the whole group.

If gifts add up to more than $50 for each individual in a calendar quarter, the amount of the gifts over $50 for each individual is treated as a resource in the month it was received.

 

55 Pa. Code § 181.262

The CAO will not count student financial assistance from loans, grants, scholarships, or work-study.

 

42 U.S.C. Section 5515(d)

The CAO will not count disaster unemployment assistance as income or a resource.         

62 P.S. 432.12

 

 

 

350.65 Excluded Income—MAGI-Related

For MAGI MA, if income is not taxable by the IRS, it is not counted for MAGI MA determinations with the following exceptions:

 

The CAO must not count the following excluded income for MAGI-related MA:

42 CFR 435.603(e)

                                                                                                                 42 CFR 435.603(e)(1)

NOTE: To be considered a gift, a monetary gift must be infrequent and nonrecurring.

 

42 CFR 435.603(e)(3)(ii)

42 CFR 435.603(e)(3)(iii)(A)

42 CFR 435.603(e)(3)(iii)(B)

 

 

 

Updated October 30, 2018, Replacing February 14, 2012