To be considered a specified relative, an individual must meet all of the following conditions: 55 Pa Code § 151.42
For TANF-related MA, be related to and have care and control of a dependent child. (See Section 327.21, Relationship to the Dependent Child.)
For MAGI-related MA, be a parent, relative, or non-relative and have care and control of a dependent child.
NOTE: This means that the individual is (a) taking part in making plans for the support, education, and care of the child (b) able to carry out those plans, and (c) asking for benefits for the child.
The individual (a) keeps a home where the child lives with him or her or (b) is setting up a home where the child will live with him or her within 30 days.
The specified relative does not need to be included in the applicant/recipient group. However, if a parent applies for MA, he or she may have to be included in the same TANF-related MA applicant/recipient group as the child. For MAGI-related MA, the applicant/recipient group follows tax filing household rules.
For TANF-related MA, a specified relative must be related to the dependent child in one of the following ways:
A blood relative, including those of half blood. This includes the following relationships:
Parent.
Aunt or uncle.
Grandparent, including great-great grandparent and great-great-great grandparent.
Other relationships prefixed by great, great-great, grand, or great-grand.
Brother or sister.
Nephew or niece.
First cousin.
First cousin once removed; that is, the child of one’s first cousin or the first cousin of one’s parent.
NOTE: The CAO must not consider second, third, etc. cousins as specified relatives.
A relative as listed above when the relationship to the child is adopted.
NOTE: The biological parent of an adopted child or a relative of the biological parent may be named as the specified relative only if one or both adoptive parents are dead or if the child returns to the biological parent’s care and control.
A stepfather, stepmother, stepbrother, or stepsister, or stepgrandparent.
NOTE: A stepparent living in the same home as the child's parent may be named a specified relative only if the parent in the home is disabled and/or unable to care for the child. Otherwise, the stepparent must meet the financial and nonfinancial conditions for another category.
NOTE: To be a specified relative, a stepgrandparent must be the spouse of a grandparent. A parent of a stepparent does not qualify as a specified relative.
Examples: Jane M. applies for cash assistance for Tommy G., who is the grandson of her husband. Her husband, Martin M. is the father of Mary G., who is Tommy’s mother. Jane may be named a specified relative, because she is married to Tommy’s grandparent.
Anna W. applies for MA for Peter C. Peter’s stepfather, Michael W., is Anna’s son. Anna does not qualify as a specified relative.
The spouse of any relative named above, even after the marriage is ended by death, separation, or divorce.
A relative of a putative father:
The whereabouts of the putative father are unknown or the putative father is dead.
The CAO decides, using available information, that the putative father is the child's biological parent.
NOTE: The CAO decision is made only to identify a specified relative and does not prove paternity. Until paternity is legally proven, a putative father must not be considered a parent or legally responsible relative. An individual must not be considered the father simply because he says he is.
A legal guardian who is living with the child, only if he or she is related to the child as described above.
A pregnant woman with no children may qualify for TANF-related MA for herself only as a specified relative.
The eligibility of the specified relative is not affected if:
The child is under the control of the court and is getting services such as probation or protective supervision; or
Someone other than the specified relative, such as another individual or a public or voluntary agency, has legal custody of the child.
NOTE: This does not apply to specified relatives when a custodial child has been removed by Children and Youth Services.
In a joint- or shared-custody situation, the court order, binding separation, divorce, or custody agreement establishing physical custody controls who the custodial parent is. In the circumstances that there is no such order or agreement or a pure 50/50 custody agreement, the custodial parent is the parent with whom the child spends most nights. In the situation where both parents spend the equal amount of nights in a 50/50 custody agreement, the parent who applies first is considered the specified relative.
Example 1: John and Betty have a common child. They do not have a formal custody arrangement and their child spends all but one weekend a month living with Betty. Betty is the custodial parent in this situation and is the specified relative. John is the non-custodial parent in this situation and is not a specified relative.
Example 2: Allen and Alyssa are divorced and have 50/50 custody of their two children. The children spend a week with each parent at a time. Allen applies for MA for himself and the children on May 1st. Alyssa applies for MA for herself and the children on May 2nd. Because the custody agreement is 50/50 and the children spend an equal amount of nights with both parents, the specified relative is whoever applied first. In this case, Allen is the specified relative as he applied a day before Alyssa.
If it becomes known to the CAO that the child in a 50/50 custody arrangement open for MA in Pennsylvania is also open for MA in another state, the CAO will make the determination of who the custodial parent is by using the following:
For MAGI MA, the custodial parent is the parent who expects to claim the child as a tax dependent in the current year. The prior year’s tax filing status does not affect current year’s expected tax filing status.
For other types of MA, the custodial parent is the parent who applied for MA for the child first.
NOTE: The MA benefit is to cover the child's medical needs during the entire period, not just when the child is with the parent who is considered the specified relative. The CAO does not have to work out any problems between the parents about the use of the MA card.
Reviewed April 29, 2024, Replacing February 14, 2024