305.5 TD GA-Related Category—MNO

TD is the GA-related category for an individual who:      

62 P.S. 442.1

55 Pa. Code § 141.81(c)(3)(v)  

 

NOTE:  A parent or stepparent can qualify for TD as a custodial parent of a child under 21 who is attending college away from home if (a) the child maintains legal residence at the parent’s home and (b) the child is under the care and control of the parent.

 

NOTE:  An individual or couple who is providing foster care for a child does not qualify for TD as a custodial parent. However, a foster parent can qualify for PD under the nonparental caretaker provisions of Section 305.43.

 

Reminder: When both parents of the child live in the household, an unmarried custodial parent can receive TD (MNO) no matter how much income the other parent has.

 

NOTE:  The amount that must be used is either the federal minimum wage or the state minimum wage, whichever is higher. Federal law allows states to require a minimum wage that is more than the federal minimum wage.

NOTE:  For smaller employers with ten or less employees, all considered full-time and each works less than 40 hours a week as part of the employer's usual practice, use the real amount the employer pays to determine eligibility.      

     55 Pa. Code § 181.1(b)

NOTE:  A third party who knows the self-employed individual’s business must verify the individual is working the number of hours that he or she claims. If no one is available to verify that, then the individual’s word may be used. After counting the gross receipts and cost of doing business, the individual’s average monthly profit when divided by the average hours worked (which must be at least 100 hours per month) must equal at least the hourly minimum wage.

 

NOTE:  Although “income-in-kind” (work for free or reduced rent) is not counted as income, the hours worked are counted to determine if the individual meets the 100-hour rule. The value of the rent when divided by the hours worked for the rent must meet or be more than the minimum wage.

NOTE:  For people whose eligibility is based upon the work requirement, past, present and ongoing work must be looked at to make sure that they are following the 100-hours-per-month work rule. If someone receives sick or has an injury that forces him or her to stop working for a while, that individual is still considered to have met the work rule if it can be shown that he or she will return to work after recovering. The 100-hour work rule applies to each month in the six-month eligibility period. The recipient must report if he or she loses a job or works fewer hours.

 

NOTE:  The Medically Needy Income Limits (MNIL) are not tied to minimum wage but are based on the State’s Family Size Allowance (FSA).  Federal regulations require the MNIL cannot be lower than the FSA and cannot be more than 133% of the FSA levels.  

305.51 Examples of How Eligibility for Benefits Is Based on Employment

 

Mrs. L., age 52, applies for MA on May 3rd while hospitalized for minor surgery. Mrs. L. has worked for the last five years for 25 hours a week at minimum wage. Her employer has verified that she will return to work on June 28th.

Mrs. L. meets the 100-hour work rule because she has a history of working 100 hours each month. She stopped working temporarily because of her illness, but it has been verified that she will return to work after she gets better.

 

Mr. P., age 46, applies for MA on June1st. He works 20 to 30 hours a week at minimum wage for a total of 100 hours of work each month. He has worked at the same company for two years, which is proven by a statement from his employer and pay stubs.

Mr. P. meets the work requirement because he works for 100 hours each month. In determining eligibility, the CAO reviewed his past work history and present condition to see if he is likely to continue to work.

Mr. J., age 23, applies for MA on June 14th . Mr. J. started working at his first job on May 28th and got his first paycheck on June 6th. His employer verifies that Mr. J. will work 20 to 30 hours a week and will work a total of 100 hours per month. Mr. J. receives minimum wage and does not expect a raise.

Mr. J. meets the 100-hours-per-month work  because he works for 100 hours per month and his employment will continue. Because Mr. J. has no work history, the CAO sets up a review in three months to check on his employment. Mr. J. understands that he must report any changes.

Mr. D., age 36, applies for MA on May 30th.  Mr. D. is employed part-time during certain times of the year. His employer gives the following information:

Mr. D. is not eligible because he does not meet the 100-hours-per month work  and it is not clear whether he will have work in the future. The CAO informs Mr. D. that he can apply in the future if things change. If Mr. D. applies in October and his 100 hours continue for six months after that, he will meet the 100-hour rule.

Ms. T., age 39, applies for MA on June 8. Ms. T. has been employed for the last year and works 96 hours a month at minimum wage. This is proven by her pay stubs.

Ms. T. is not eligible because she does not meet the 100-hours-per month work rule. The CAO lets Ms. T. know that she can apply in the future if things change.

 

Ms. A. applies for MA on September 10. She has been employed as a child-care provider. The employer has given the following information:

 

Ms. A. meets the 100-hour minimum wage because her total monthly earnings are more than 100 times the minimum wage (now $7.25 x 100 = $725).

An applicant for MNO works for an employer who pays a very low wage but also provides free rent in exchange for working. The individual works more than 100 hours per month. He or she meets the 100-hour rule if (a) he or she works at least 100 hours and (b) the money earned plus the full value of the rent equals or is more than the minimum wage times 100.

 

TD with Program Status Code 55 may be approved for a 30-day NCE period if a medical assessment is needed to determine disability for GA cash, SSI-related, and GA-related MA categories (PD). TD 55 does require that the individual be issued a 30-day ACCESS card. (Section 305.421.)

 

A woman who is open for Select Plan can be authorized TD55 for a 30 day NCE for a disability assessment.

 

NOTE:  GA applicants age 59 and older must be reviewed for TD 00. For applicants under age 21, the appropriate TANF-related MA category must be opened, as they do not meet any TD eligibility criteria.

NOTE:   If an applicant claims a permanent disability but his or her income or resources is more than the MNO income limit, a 30-day NCE may be approved under PH 00 to pay for the medical exam. The income and resources must not be more than the Healthy Horizons income and resource limits. These guidelines also apply to individuals age 59 or older and age 18–21 (if the 18-year old is not a full-time student in a secondary school). Income of the individual’s parents will not be deemed

 

NOTE:  Before opening TD 55, the CAO must check the third-party liability file to make sure there is not active Medicare insurance for the same 30-day NCE period. Active Medicare insurance indicates that a disability-related category must be considered.

 

 

 

Updated February 14, 2012, Replacing June 28, 2007