The CAO will consider the gross amount of unearned income when determining eligibility for MA.
Unearned income includes, but is not limited to, the following:
Retirement benefits, private pensions and annuities, including an amount deducted for an insurance premium.
NOTE: If a pension is “fixed” (meaning the amount does not change), then the CAO will enter unearned income code 50.
NOTE: If an applicant receives a pension that is not in U.S. dollars, the CAO will determine how much the amount is equal to in U.S. dollars. The CAO can verify the exchange rate by doing an online search, checking a newspaper, or calling a local bank or currency exchange. The CAO will assume that the rate remains the same until the next renewal or SAR, unless the individual reports a change. The CAO may use an average of the last six months of exchange rates to determine the rate for the next six months.
Social Security benefits (RSDI), including an amount deducted for the Medicare Part B premium.
Veterans Administration (VA) benefits.
NOTE: The aid and attendance part of VA benefits must be excluded for SSI-related categories. If the recipient makes any part of the benefit available to support a dependent, that part must be counted as income for the dependent.
Reminder: It is possible for an individual to receive VA benefits and/or Social Security (RSDI) under multiple claims numbers. For example an individual may be receiving a VA pension under their own claim number and other VA compensation under their deceased spouse's claim number. In these instances, income from each claim number should be listed on separate Unearned Income screens in eCIS. In order to differentiate between multiple incomes, claim numbers should be entered in the "source field" on the Unearned Income screen in eCIS. The CAO should follow this procedure for other types of income as well (e.g., multiple claims with SSA).
Unemployment compensation (UC).
NOTE: The 2.4% UC reduction increased to 3.2% effective January 7, 2023. The reduction is applied to the regular weekly benefit amount and the dependent’s allowance only. The reduction does not apply to federal compensation programs like Emergency UC, Extended Benefits, Trade Readjustment Allowances, and Disaster Unemployment Assistance.
Workers' compensation.
Income from insurance policies that provide cash payments directly to the individual.
NOTE: If the insurance is assigned to a medical provider, it will be treated as a third-party resource. Because the provider will receive the payment, it will not be treated as income.
Dividends, royalties, and interest in the calendar month posted.
Loans, gifts, and contributions (see Section 350.32, Loans, Gifts, and Contributions).
Educational assistance (see Chapter 314, Students).
Income deemed available from a legally responsible relative (LRR) (see Chapter 355, Deeming Income and Resources).
Net capital gains (profit after subtracting capital losses).
NOTE: Capital gains from the sale of property are counted as a resource for Non-MAGI budgets.
Capital gain distributions.
Rental income.
NOTE: Rental income may also be earned (see Section 350.4, Rental Property Income).
Sales agreement income.
NOTE: Consider payments from a sales agreement or contract as unearned income. The amount of the sales agreement or contract is not considered an available resource.
Lump sum nonrecurring payments (see Chapter 357, Lump Sum).
Unearned lump sum payments include, but are not limited to, the following:
Federal, state, and local tax refunds.
Life insurance benefits.
Inheritances.
Delayed RSDI, UC, or Workers Compensation benefits.
Lottery winnings.
Past-due court-ordered support payments.
A prize is a cash payment won in a contest, lottery, or game relating to luck. An individual usually receives an award because of a decision by a court, board of arbitration or similar legal body. A prize or award may be received as a lump sum or as a recurring payment.
Inheritances.
A cash inheritance received as a one-time payment must be treated as a lump sum.
The CAO will verify all unearned income if used in the eligibility determination and record it in the case record.
Support paid by an LRR for a child or spouse, whether it is court ordered, voluntary, or paid directly to the individual, is considered when determining eligibility for MA. The amount of court-ordered support or alimony may be verified through the Pennsylvania Child Support Enforcement System (PACSES), by a copy of the court order, a copy of a check, or a written statement from the Domestic Relations Office.
NOTE: For information about the income of a child with special needs, see Section 315.4.
For MAGI MA, all support paid by an LRR for a child, whether it is court ordered, voluntary, or paid directly to the individual, is excluded when determining eligibility for MAGI-related MA.
Spousal support, court-ordered or voluntary, is counted when determining eligibility for MAGI-related MA See Chapter 312 Modified Adjusted Gross Income, Section 312.42 Unearned Income for information about cash support.
For TANF-related or GA-related categories only, a cash contribution or loan from an LRR will be counted as support income. If the contribution or loan is from a putative father, the CAO will count the payment as support if the mother or the putative father verifies, in writing, that the payment is child support.
For TANF-related MA, the CAO will give one support disregard. The disregard is one of:
Actual amount of support up to $50 for spousal support.
Actual amount of support up to $100 if there is one countable child in the budget group.
Actual amount of support up to $200 if there is more than one countable child in the budget group.
NOTE: Child support is the child's income and should be assigned to the child in eCIS.
The budget group gets only one support disregard. If the budget group receives both spousal and child support, the CAO will apply the support disregard that will most benefit the budget group.
Reminder: The individual is not required to pursue support to be eligible for MA benefits.
Disregard does not apply to past-due support payments. Money paid to cover past-due support payments is considered a lump sum payment. (See Chapter 357, Lump Sum.)
Example: Allen receives TANF-related MA for self and their two children. Allen has a court order for $300 a month in support. Allen receives $900 for the first payment, which includes two months of past-due payments. The CAO counts $100 ($300 - $200) as unearned income for the current month. They count $600 as a lump-sum payment.
The CAO will clearly explain to cash assistance and MA applicants or recipients that they do not have to pursue support to be eligible for MA.
Any court-ordered child support received through the EPPI delivery system will be treated the same as any other source of income. It will be counted as income in the month the individual receives it. Any money remaining in future months is counted as a resource.
The CAO will consider a cash loan, gift, or contribution made to a member of the applicant or recipient group as follows:
Loan- money lent usually for a temporary use.
Gift- money or property voluntarily transferred by one person to another without compensation; gifts are usually received on an irregular and infrequent basis.
Contribution- recurring financial support that cannot be excluded as a loan or gift.
The CAO will not count any money that is loaned to the applicant/recipient group. The loan must have a repayment statement. Interest earned on the money loaned will be counted as income.
NOTE: The CAO should advise the individual to keep the money from a loan in a separate account so that it is identifiable.
Exception: For TANF-related and GA-related categories, money loaned by an LRR is counted as support.
For MAGI-related MA, all monetary and non-monetary gifts are excluded. A monetary gift (money or currency given as a gift) must be infrequent and non-recurring to be considered a gift.
For TANF-related and GA-related categories, a small amount of money given as a gift from an LRR or another individual will not be counted. The gift is excluded as long as it is $50 or less per individual in a calendar quarter. If the gift is meant for more than one individual, the CAO will divide the amount among the number of individuals it is meant to cover. The amount over $50 per applicant/recipient group member will be counted as a resource in the month the individual receives it.
For SSI-related categories, if a contribution is given on a regular basis to help support and care for them, the CAO will count the payment as unearned support income.
For MAGI-related MA, a cash contribution is only counted when it is provided by a tax filer to a tax dependent who is not the tax filer’s spouse or child (biological, adoptive, or step). The CAO must count the full amount after the first $50. (See Section 312.42.)
For TANF-related and GA-related categories, a cash contribution received from a individual who is not an LRR is counted as unearned income unless it is excluded as a loan or gift. If a contribution is received from an LRR, the CAO will count the payment as support.
The CAO will consider interest income in the calendar month in which it is posted, unless it is excluded in this chapter. (See Section 350.6.)
NOTE: The interest income does not need to be withdrawn or actually received by the individual.
For SSI-related categories only, the CAO will not count interest income if:
The individual receives it only once in a calendar quarter.
The total of the interest income plus any other irregular unearned income is not over $20 for the month when the individual receives it.
Examples:
Chris receives interest on a savings account every other month: On April 1, the interest is $8.35; on June 1, it is $9.15; on August 1, it is $9.85; and on October 1, it is $10.20. The CAO counts the interest received on April 1 and June 1 as unearned income, because the interest was received more than once in the calendar quarter. The interest received on August 1 is excluded. The interest received on October 1 is counted because interest will be received on December 1, which is in the same calendar quarter.
Jesse receives quarterly interest on a savings account. On April 1, the interest is $12.35, and on July 1 it is $13.15. On July 15, Jesse wins $50 in the lottery. The CAO does not count the interest Jesse receives in April. They count both the interest and the lottery winnings in July, because the total is more than $20.
For MAGI-related categories only, the CAO will not count interest income at the time it is posted if the interest accrued is considered tax-deferred.
For TANF-related and GA-related categories, the CAO will count interest in full unless it is excluded by law. (See Section 350.6, Income Exclusions)
For SSI-related categories, the CAO will deem income available to the applicant or recipient group from a spouse who is living with the individual and who is not applying for or receiving TANF, GA, SBP, SSI, or MA.
For TANF-related and GA-related categories, the CAO will deem income available to the applicant/recipient group from a spouse or parent who is living with the individual and who is not receiving TANF, GA, SBP, SSI or MA.
NOTE: See Chapter 355, Deeming Income and Resources.
There is no deeming for MAGI-related MA categories.
If the individual receives a benefit that is less than the full amount because of an insurance premium, court-ordered support, recovery of an overpayment that took place in the past, or other deductions, the CAO will count the amount of the benefit before the reduction.
Exception: If an SSI-related MA eligible individual receives a benefit that is reduced to make up for an overpayment, and if the overpaid amount was counted in determining eligibility for cash assistance or MA when the overpayment happened, the CAO will count the amount of the benefit the individual receives. (See Section 350.63, Excluded Income—SSI-Related.)
Updated June 12, 2024, Replacing October 30, 2018