When an MA recipient reports a temporary absence from the county of residence, the CAO must take action depending on why the individual is away. The CAO must find out:
The type of absence (out of the county, out of the state, or out of the United States).
Why the individual is away.
How long the individual will be away.
The individual’s new address.
Individuals are still eligible for benefits during a temporary absence from their county of residence if they:
Are staying in another Pennsylvania county.
Plans to return when the purpose for the absence is completed.
Continues to meet all other eligibility rules.
If the recipient reports a temporary change of address to another Pennsylvania county and continues to meet all eligibility rules, the CAO must continue benefits at the new address in the other county.
During a temporary absence, the CAO must redetermine an individual’s eligibility using normal renewal procedures.
When an individual reports temporarily living in another county, the CAO must take the following actions:
Determine whether the applicant/recipient group is still eligible for MA.
Make the address change, and issue a medical replacement card if one is needed.
Send a confirming notice to the new address, and make sure that the individual receives the MA card at that address.
Note the change of address in the case record or the e-CIS case comments.
If a new review of eligibility is needed due to a change in circumstances while a recipient is temporarily living in another county, the CAO must take the following actions:
Write to the recipient letting the individual know what information is needed to establish continued eligibility and when the information is due in the CAO.
NOTE: MA is continued as long as facts presented by the individual are consistent and reasonable. The CAO must set up a plan for the individual to give proof within 30 days from when the information about the change is received.
Contact the CAO in the county of temporary residence if more information or an individual interview is needed.
Make any required changes.
Send the individual notice of a change in eligibility.
If a partial renewal for MNO is due while an individual is temporarily absent, the CAO must take the following actions:
Send a PA 600R for the individual to fill out, with instructions and a due date for when the completed, signed form is due in the CAO.
Make any required changes to the budget or discontinue MA if the applicant/recipient group no longer meets eligibility requirements or fails to return the PA 600R.
Send the individual appropriate notice of a change in eligibility.
If a complete renewal is due while the individual is temporarily absent, the CAO must take the following actions:
Provide the individual with a renewal packet.
Review the factors that make the individual eligible.
Make any required changes or discontinue MA if the applicant/recipient group no longer meets eligibility requirements or fails to complete the renewal process. Send the individual an advance notice telling when and why benefits will be stopped
If the individual asks for a transfer of the individual's case to the CAO in the county of temporary residence, or if the CAO determines that the absence is permanent, the CAO must follow the steps for an intercounty transfer.
An individual who continues to meet eligibility requirements during a temporary absence from the state and plans to return to Pennsylvania can keep getting benefits. The CAO must continue to provide MA to recipients while they are in another state when:
Emergency medical care is needed while the individual is temporarily away from home.
The individual's health would be at risk if the service was put off until returning home.
Medical services are needed and the individual's health would be in danger if being required to travel to Pennsylvania.
The CAO determines, on the basis of medical advice, that the needed medical services or resources are more readily available in the other state.
It is common practice for individuals in a certain location to use medical services in a neighboring state.
The CAO should discontinue MA, with advance notice, if:
The CAO finds out that the reason for the temporary absence is done and that the recipient has still not returned to Pennsylvania.
Another state has decided that the individual is a resident there for MA purposes.
If a recipient reports a temporary move from Pennsylvania, the CAO must take the following actions:
Find out why and how long the individual will be absent, and determine whether the applicant/recipient group is still eligible.
If the individual asks for a temporary change of address, put the original Pennsylvania address in the alternate address field and narrate that it is a temporary absence.
Send the individual a PA/FS 162-C to confirm the address. Let the individual know that if the individual is gone longer than expected, the individual must contact the CAO.
Create an alert for the expected date of return to Pennsylvania
.
If the individual does not contact the CAO by the expected date of return:
Contact the individual by phone or mail to find out why they are still absent.
Create a new alert if the temporary absence will continue.
Continue to monitor the period of absence.
If the CAO determines that the applicant/recipient group no longer meets MA eligibility requirements, has abandoned its Pennsylvania residency or is trying to establish residency in another state to receive MA from that state, discontinue MA and send an advance notice telling when and why benefits will be stopped.
If a partial or complete renewal is due during the temporary absence:
Send the individual a PA 600R and instructions for completing the PA 600R.
Review the factors that make an individual eligible
Make any required changes to the budget or discontinue MA if the applicant/recipient group is no longer eligible or does not complete the renewal process.
Send the individual an advance notice telling when and why benefits will be stopped.
Narrate all changes, plans and actions in the case record or CIS case comments.
A move to another county in Pennsylvania is considered permanent if the recipient does not plan to return to the county where the individual used to live.
In order to ensure uninterrupted MA coverage and that CAOs are in compliance with Federal requirements for MA inter-county transfers, the following procedures are used.
NOTE: The MA intercounty transfer process applies to all MA budgets, whether or not they exist with a SNAP or cash assistance budget.
When an individual reports an address change to another county within the Commonwealth, CAOs will process an Intercounty Transfer (ICT). The county that receives the report of address change will:
Applications that confirm or report a cross-county move must not be rejected with the 037 reason code. If the case is in an active workflow within the same CAO, follow local CAO procedures. If the case is in an active workflow in another county, coordination must occur through ICT Liaisons.
323.631 Actions in the Current Case Record:
1. Identify if there is a change in household circumstances including: household composition, income, resources, or expenses
2. Review all pending Work Items identified via Assignment Search due within the timeframe of the closure date.
3. If a household member is receiving State Supplementary Payment (SSP), review State Data Exchange (SDX/IEVS Exchange 6) for address information.
a. If the address has been updated, continue.
b. If the address has not been updated, continue with updating their new address in eCIS and proceed with the following steps:
i. Advise individuals to change their address with the Social Security Administration (SSA).
ii. Complete the PA1781 and send to SSA.
iii. Transfer all other benefits but leave all A/J/M budgets open in their current record.
4. Request verification, if needed, and allow no more than 30 days for the individual to return documents before continuing.
Note: If verification should be returned to a county other than the active case record, make certain the county drop-down is updated on the Pending Verification screen.
5. Identify if a SAR or renewal is due within the timeframe of the ICT advance closure date(s) and/or within two months of closure in the losing county.
a. If a SAR or renewal is due prior to the advance closure date:
i. Request any necessary verifications.
ii. Complete the SAR or renewal prior to continuing the ICT process.
iii. If the SAR or renewal process is not completed by the established due date, close benefits without completing the ICT.
6. Access the case in Maintenance mode and update current case record.
Note: Address any pending or overdue applications, renewals, or SARs prior to completing the ICT. Case updates may be completed in those workflows when appropriate.
a. Change address
i. To identify new gaining county, please use the County/Zip Locator https://tools.usps.com/go/ZipLookupAction!input.action
ii. If moving to a districted county, determine district
1. Allegheny CAO – Allegheny Zip Codes by Area
2. Delaware CAO – Delaware Zip Code List
3. Luzerne CAO – Luzerne Zip Code List
4. Philadelphia CAO – Philadelphia CAO Address List
5. Westmoreland CAO – always assign new case to Greensburg District
6. Washington CAO – Washington Zip Code List
b. Data enter any other changes (phone number, household composition, PEER status, income, resources, shelter and utility allowance, rent or mortgage, any other expenses or changes)
7. Close using Reason Code 099, Option 3 for ICT.
8. Enter a narrative using the template in the losing county’s record. See Narrative Template
323.632 Actions in the Gaining CAO Case Record
1. Obtain a non-Application number assigned to caseload 4545.
2. Complete case opening, ensuring that eligibility results and begin dates align with their eligibility at the time of closing in the losing county.
3. Re-enter the case in maintenance mode and adjust SAR and renewal dates. If due within two months of closure and the correct date will not be able to be entered when the case is opened:
a. Enter the earliest date possible
b. Narrate the date entered and reason
c. Send a manual SAR or renewal with the correct due date with the gaining CAO’s address.
i. If complete SAR or renewal is provided, gaining CAO will process. Manually update the new certification dates when needed.
ii. If complete SAR or renewal is not provided follow the steps outlined in Ex Parte Review Desk Guide and MAEH 376. Ensure at least 30 days have passed since the manual packet was sent then manually close MA.
4. Enter a narrative using the template in the gaining county’s record. See Narrative Template
5. Send all system notices
6. Advise the client that their benefits have been transferred.
a. Discuss any eligibility changes due to household updates.
b. If receiving MA or CHIP, inform the client to contact Health Choices at 800-440-3989 or Office of CHIP (800-986-5437) if they want to change their MCO.
323.633 Forced Closing for Immediate Medical Need for New Managed Care
If there is an immediate medical need to have case closed before ICT closure date, follow the steps below ONLY AFTER an 099 closing has been completed and if an immediate opening is needed.
a. Enter the case in Maintenance mode.
b. Navigate to the budget action screen and enter closure reason 063.
c. Navigate to the Run Eligibility screen.
d. Change “Apply Adverse Action” to No and run eligibility.
e. Note the new closure date, suppress any notices, and submit the case.
f. Narrate clearly the action taken and why notices were suppressed.
g. Ensure the case is reopened in the gaining CAO prior to the closure date to avoid any lapse in coverage.
A recipient who makes a permanent move to another state or country is not eligible for continued MA benefits.
Exception: An individual who moves from Pennsylvania to an institution in another state may still be considered a Pennsylvania resident. See Section 323.23, Individuals Living in an Institution, and Section 323.24, Individuals Placed by the State in an Out-of-State Institution.
When the CAO finds out that an individual has moved permanently out of Pennsylvania, it must take the following actions:
Discontinue MA.
Send the individual a notice notifying the individual when and why benefits were stopped:
If the individual has not submitted a signed, written request to close MA, an Advance Notice must be sent to the individual.
If the individual has submitted a signed PA1829 or written notice, send a Confirming Notice to the individual.
Note the reasons for the action in the case record or CIS case comments.
A recipient who moves permanently to another country is not eligible for continued MA benefits.
If a recipient reports a temporary absence from the United States, the CAO must continue MA for 30 days.
NOTE: The following are considered part of the U.S.: the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and Swain's Island.
On the 30th day, the CAO must assume that the recipient has made a permanent move outside the country unless all of the following apply:
Illness or other good cause why an individual cannot return to Pennsylvania at the end of 30 calendar days.
The individual has not taken steps to establish residence outside the United States.
The individual continues to meet all other eligibility conditions.
The individual provides written proof of the inability to return.
As long as the recipient continues to meet all of the above conditions, the CAO must continue MA benefits.
A recipient who is temporarily out of the U.S. must comply with renewal requirements.
If the CAO decides that the individual (a) no longer meets eligibility requirements or (b) has not returned to the United States and has not shown that the individual continues to live in Pennsylvania, then the CAO must discontinue MA.
If an individual reports that he or she will be temporarily out of the U.S. for less than 30 days, the CAO must take the following actions:
Tell the individual to let the CAO worker know immediately upon returning to the U.S.
Create an alert for the expected date of return.
If the individual does not contact the CAO within 30 days after leaving the United States:
Discontinue MA.
Send the individual an advance notice telling when and why benefits were stopped.
If the individual reports the inability to return to the United States within the 30-day period:
Determine whether the applicant/recipient group meets all requirements for continued MA.
Create an alert for the expected date of return.
If a partial or complete renewal is due during the temporary absence:
Send the individual a PA 600R.
Review the factors that make an individual eligible.
Make any required changes to the budget, or discontinue MA if the applicant/recipient group no longer meets eligibility requirements or does not complete the renewal process.
Send the individual an advance notice telling when and why benefits will be stopped.
Discontinue MA at any time that the applicant/recipient group no longer meets requirements.
Note the reasons for all actions in the record.
Updated April 30, 2026, Replacing March 17, 2026