Each individual or representative who signs an application for benefits (including the PA 600 series applications and COMPASS applications) needs to give the County Assistance Office (CAO) true and complete information on everything that may affect eligibility. 55 Pa. Code § 125.24(c)(3)
All Medical Assistance (MA) budgets are enrolled in semiannual reporting (SAR), except for the following:
Individuals receiving Long-Term Care (LTC) services.
Individuals who are elderly.
Individuals who are disabled.
Exception: MAWD recipients are enrolled in SAR.
Pregnant women.
Children under one year of age.
Children living with a relative other than a parent when the adult’s income does not affect eligibility.
Children in foster care or adoption assistance programs.
Individuals who are approved in a TD 55 category.
Whether an individual is enrolled in SAR or not, the individual or his or her representative will report any change by the tenth day of the month after the change. Changes include the following: 55 Pa. Code § 125.24(d)(1)
A change in information that was given before.
A change in an individual’s situation that may affect his or her eligibility.
A change that may affect the category or type of MA an individual receives.
A change in income will be reported by the tenth day of the month after the month the individual actually gets it.
Exception:
Individuals getting LTC services in the community or in an institution will report all changes within ten calendar days.
Example: Mary’s child moves from her household on April 28th. On the same day, Mary starts a new job. She expects to get her first paycheck on May 12th. Mary will report her child’s move by May 10th She does not need to report the change in income until June 10th, as she will not get the income until May.
When an applicant is found eligible, the CAO will talk with him or her about his or her duties, including reporting changes, and set up a plan for reporting. At application and at renewal, the individual or his or her representative will read and sign the affidavit on the application. If the individual cannot read or understand it, the CAO will read or explain it to the individual. The CAO will give the individual or the individual's representative a copy of the rights and duties.
Note: The online application (COMPASS) requires the applicant to review the rights and responsibilities and allows the individual to print them. The CAO does not have to provide this page to online applicants.
Updated January 10, 2013, Replacing February 14, 2012,