339.1 General Policy for Transitional Medical Assistance (TMA)

Begin Date for Transitional Medical Assistance (TMA) Budgets, PMA-21599-339 (Published January 8, 2024)

 

MA Modified Adjusted Gross Income (MAGI)-related (MG27) recipients who lose eligibility due to an increase in income may be eligible for TMA. The period of eligibility depends on the source of income.

 

55 Pa. Code § 140.401

42 U.S.C. 1396r – 6

 

 

55 Pa. Code § 140.551

 

 

TMA budget groups are built using the same target types as MG27:

 

 

339.11 Eligibility Requirements

The CAO must determine eligibility for TMA using rules in this chapter and the following chapters.

 

 

 

339.12 Definitions

Earned Income:  income received from employment.

 

Spousal Support:  income received by one spouse from the other pending divorce.

 

Alimony: income received from an ex-spouse after divorce.

 

TMA Certification Period:  the four-month (MG23) or twelve-month (MG71) TMA eligibility period.  

 

NOTE: The certification period starts the date that the change is processed. If the change in income is not reported timely, the individual must still be given a full 12 month TMA period. See Chapter 370, Reporting Changes, Section 339.2 TMA Eligibility.

 

NOTE: An MG 71 renewal cannot be processed prior to the month in which it is due.  If it is processed prior to the renewal month, the budget will not close, and the individuals will not be evaluated for other categories of MA.  If the renewal is processed prior to the renewal month, the CAO must set a reminder to run a renewal workflow again in the month of renewal in order to close TMA and evaluate other eligibility.

 

 

 

Updated January 25, 2024, replacing  May 23, 2018