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Pennsylvania Statutes Title 62 P.S. Poor Persons and Public Welfare § 442.1. The medically needy; determination of eligibility

Current as of January 01, 2025 | Updated by Findlaw Staff

(a) A person shall be considered medically needy if that person meets the requirements of clauses (1), (2) and (3):

(1) Resides in Pennsylvania continuously for ninety days immediately preceding the effective date of eligibility, except for persons eligible for federally funded categories of medical assistance.

(2) Meets the standards of financial and nonfinancial eligibility established by the department with the approval of the Governor. In establishing these standards the department shall take into account:

(i) the funds certified by the Budget Secretary as available for medical assistance for the medically needy;

(ii) pertinent Federal legislation and regulations; and

(iii) the cost of living.

(3) Complies with subclause (ii):

(i) Deleted by 2019, June 28, P.L. 43, No. 12, § 3, effective Aug. 1, 2019.

(ii) Is not eligible for cash assistance but is:

(A) a child under twenty-one years of age;

(B) a custodial parent of a dependent child under twenty-one years of age;

(C) a person fifty-nine years of age or older;

(D) a refugee for whom Federal financial participation is available;

(E) a pregnant woman;

(F) a person with a disability who is receiving Social Security disability benefits, who has been referred to the Social Security Administration for a determination of eligibility for Supplemental Security Income or who is under review for a disability by the department based upon Social Security disability criteria; or

(G) a person who verifies employment of at least one hundred hours per month earning at least the minimum wage.

(b) Deleted.

(c) Medical assistance benefits can be authorized retroactively for an eligible person who requests coverage for an unpaid medical expense which was incurred during a period up to three months prior to the month of application. In determining eligibility, all income received or expected to be received in a six-month period shall be counted even if the person requests medical assistance coverage for less than six months. If retroactive medical assistance coverage is requested, the six-month period can combine both retroactive and prospective periods. Medical assistance coverage can continue as long as the need exists, but no longer than the six-month period from which income is counted.

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Cite this article: FindLaw.com - Pennsylvania Statutes Title 62 P.S. Poor Persons and Public Welfare § 442.1. The medically needy; determination of eligibility - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-62-ps-poor-persons-and-public-welfare/pa-st-sect-62-442-1/

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