Appendix E: Home and Community Based Services (HCBS) Spend-Down Notice Text

Eligible for HCBS in a Monthly NMP Spend-Down Category (PA/PJ/PM 21):

You qualify for Medical Assistance (MA) and payment of Home and Community Based Services (HCBS) in the _____ Waiver for a limited period from ___ to ___.  You qualify for these benefits with a monthly spend-down.  This means you must incur $___in medical expenses each month to be eligible for the rest of the calendar month. See the Spend-down section for more details on what medical expenses were used. A MA benefit card (PA ACCESS card) will be sent to you unless you were given one before.

The Service Provider/Coordinator will notify you when your HCBS will begin.

62 P.S. § 441.8; 55 Pa. Code §§ 141.71, 178.1, 181.1, 181.13

 

Eligible for LIFE in an Ongoing NMP Spend-Down Category (PA/PJ/PM 22):

You qualify for Medical Assistance (MA) and payment of Home and Community Based Services (HCBS) in the Living Independence for the Elderly (LIFE) Program effective _________. You qualify for these benefits because you have medical expenses that are used to spend-down your income. This means you must incur and pay $______ in medical expenses each month to be eligible. See the Spend-down section for the amounts of each medical expense you are responsible to pay the provider. The Service Provider/Coordinator will notify you when your HCBS will begin.

62 P.S. § 441.8; 55 Pa. Code §§ 141.71, 178.1, 181.1, 181.13

 

Eligible for HCBS in a MNO Spend-Down Category (TA/TJ 22):

You qualify for Medical Assistance (MA) and payment of Home and Community Based Services (HCBS) in the _____ Waiver.  You qualify for these benefits because you have medical expenses that are used to spend-down your income. See the Spend-down section for more details on what medical expenses were used. A MA benefit card (PA ACCESS card) will be sent to you unless you were given one before.

The Service Provider/Coordinator will notify you when your HCBS will begin.

62 P.S. § 441.8; 55 Pa. Code §§ 141.71, 178.1, 181.1, 181.14

 

Reminder: Notice templates are available in the “Long-Term Care Forms” folder on DocuShare.

 

Updated September 30, 2019, Replacing March 12, 2012