A lump sum is a nonrecurring cash payment. It may be earned or unearned.
The CAO will count a lump sum payment received by the following individuals:
For MAGI, a member of the tax household, or household in accordance with non-filer rules. The CAO will count lump sum lottery and gambling winnings of $80,000 or more paid in a single payout only for the individual who claimed the winnings. See Section 357.43.
For Non-MAGI,
a member of the applicant/recipient group.
a legally responsible relative (LRR) who is living with the applicant/recipient group and who is not receiving TANF, GA, SBP, SSI, or Medical Assistance (MA). The CAO will count the amount of lump sum deemed available to the applicant/recipient group. (See Chapter 355, Deeming Income and Resources.)
The CAO will not count a lump sum that is excluded as a resource or as income. (See Chapter 340, Resources, and Chapter 350, Income).
Lump sums are treated differently for MAGI categories than non-MAGI MA categories. For MAGI MA categories, lump sums are treated as income in the month the lump sum is received, for both unearned and earned lump sums, with the exception of lottery and gambling winnings of $80,000 or more received in a single payout. See Section 357.43.
For non-MAGI MA categories: A lump sum may be counted either as a resource or as income. The CAO will count a lump sum as income if that would be more beneficial to the individual and if the individual agrees to have it counted that way.
NOTE: For individuals who received a lump sum before September 11, 1999, rules from before that date apply. Those rules allow the amount of the lump sum that is left over to be excluded as long as it is kept separate.
When an individual decides how a lump sum will be treated and the CAO approves the action, the decision cannot be changed for that lump sum.
For MAGI MA categories, the lump sum is counted as income only in the month it is received, with the exception of lottery and gambling winnings of $80,000 received in a single payout. See Section 357.43.
The individual must prove the following:
55 Pa. Code § 178.3 55 Pa. Code § 181.3
That he or she owns the lump sum.
The date, amount, and individual or agency that made the lump sum payment.
The amount of any allowable deductions.
What he or she did with the lump sum.
For MAGI MA, individuals must provide proof of the lump sum payment only if applying for or receiving MA in the month the lump sum is received. If an individual receives a lump sum and fails to report it, the CAO must review for a potential overpayment in the month the lump sum was received.
The CAO will help the individual obtain proof. The CAO will not turn the individual down for MA if he or she doesn’t have proof but cooperates. The CAO will record the proof in the case record. If the individual cooperates but can’t obtain proof, the CAO will determine the amount of the countable lump sum based on the best available information.
Updated September 28, 2020, Replacing September 5, 2018