376.1 General Policy

Closing Medical Assistance (MA) Budget(s) on Cases with Unaligned Renewal Dates, PMA-21968-376 (Published November 7, 2024)

Transitioning from Medical Assistance (MA) to the Children’s Health Insurance Program (CHIP) at Renewal, PMA-21663-376 (Published March 4, 2024)

Processing Renewals for Household with Individuals Who Can Be Renewed Through Ex Parte and Individuals Who Cannot, PMA-21483-376 (Published September 11, 2023)

Use of Data Exchange Information during the Medical Assistance (MA) Renewal Process, PMA-21408-376 (Published June 26, 2023)

Ex Parte Process for Medical Assistance (MA) Cases with a Resource Test and/or with Other Benefits (Combination Cases) on the Cas, PMA-21294-376 (Published March 31, 2023)

Use of Data Exchange Information During the Medical Assistance (MA) Renewal Process , PMA19712376 (Published August 16, 2021)

Enhanced Medical Assistance Renewals (EMAR) and Non-Modified Adjusted Gross Income (MAGI)-Related Medical Assistance (MA) , PMA19712376 (Published January 7, 2020)

 

A renewal is a periodic review of Medical Assistance (MA) eligibility which can be completed by:

55 Pa. Code § 133.73

55 Pa. Code § 133.83

42 CFR 435.916

 

Renewal forms and signatures can be submitted via mail, fax, COMPASS, telephone, and in-person.

 

Verification documents can be submitted via mail, fax, COMPASS, and in-person.

 

 

 

Note:  If an individual turns in the wrong application or renewal form, they do not need to complete another one. If information is missing, the County Assistance Office (CAO) can get it by letter or phone or by using pages of the PA 600 or a different application.

 

 

The CAO must decide when to review eligibility on the basis of expected changes in an individual's situation and on the required time frame for each type of program and category of MA.

 

If an individual no longer meets the eligibility conditions for MA, the CAO must take action to discontinue benefits and refer the individual to other medical or health programs, including the Children's Health Insurance Program (CHIP) and the Federally Facilitated Marketplace (FFM).

 

A renewal of MA eligibility may be completed at the same time as renewal of other programs as long as all information necessary for the MA determination is available with the renewal for the other program.

 

Note: Eligibility for MAWD (PW0/66), TMA (MG71), and BCCPT (PH20) budgets must not be reviewed prior to renewal date.

 

Updated December 11, 2024, Replacing January 23, 2020