A person may make a request for burial payment orally or in writing. When the CAO receives a request for burial payment, it will determine if the following criteria are met before sending a PA 118 – Burial Payment Request to the requestor:
1. The deceased person’s assistance status meets the requirements to qualify for payment. See Section 890.11, Who Qualifies for Payment.
2. The request is made by an acceptable representative. See Section 890.21, Source of the Request.
3. The initial request is made prior to the actual burial. If not, determine the reasons for the delay. See Section 890.22, Date of the Request.
4.The funeral director is an enrolled provider. If not enrolled, refer the funeral director to the Office of Medical Assistance Programs for enrollment. See Section 890.23, Status of the Funeral Director.
5.The total value of the deceased person’s countable resources is $1,499 or less. See Section 890.31, Resources.
The request for payment should be made by one of the following:
A relative.
A legal guardian.
A friend.
A representative of a state institution.
A representative of a fraternal society of which the deceased was a member.
A representative of a charitable or religious organization.
The CAO will not accept an initial request from a funeral director or from anyone acting for the funeral director. The funeral director may arrange with the CAO for a request for payment on behalf of any of the persons listed above.
A request originated by a person other than those listed above must be accompanied by an "unfit" certificate issued by the Anatomical Board, Department of Health, declaring the body unfit for anatomical purposes.
The request for payment is normally accepted only when it is made before burial. If the request is made after the burial, the CAO will determine the reasons for the delay. The CAO will not deny a burial payment because it received the request after the burial.
The CAO must submit a Burial Payment Request Form (PA 118) within 30 days of the date of death. If the request is made after 30 days from the date of death, the CAO will include a statement explaining the reasons for the delay. The CAO submits the statement with the PA 118 to the Office of Medical Assistance Programs (OMAP).
55 Pa. Code § 283.6 55 Pa. Code § 283.7
If the funeral director is waiting for notification of a resource that may reduce the DHS payment, the person requesting payment must submit the PA 118 within 15 days from the date the funeral director receives payment or notification regarding payment from the resource, whichever is sooner.
Payment for burial is made to funeral directors who are enrolled with the Office of Medical Assistance Programs (OMAP). Funeral directors are subject to the same enrollment procedures and requirements as medical providers.
Payment cannot be made to funeral directors who are not enrolled with OMAP. If the CAO does not know if the funeral director is enrolled, it must use the MA Provider Inquiry transaction to determine the funeral director’s status.
Funeral directors may call 1-800-537-8862, option 2, option 4, option 2, to request enrollment information or to receive a paper copy of the application. The funeral director may also enroll by completing an enrollment application at: PROMISe Enrollment Information.
Updated July 25, 2024, Replacing April 29, 2019