Section 181.2. Definitions

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

Applicant/recipient—A person who is applying for, or receiving, MA or a group of related persons who are living together and who choose to apply for, or receive, MA as one group.

Calendar quarter—A period of 3 full calendar months beginning with January, April, July or October.

Community spouse—The spouse living at home who has a spouse who had lived at home but is now an institutionalized spouse.

Countable net income—Income counted in determining income eligibility for MA, which is actual and deemed income less appropriate exemptions, deductions and disregards.

Deemed income—Income which is attributed to the applicant/recipient whether or not the income is actually received.

Earned income—Money or other compensation received in return for services rendered.

Full-time employment—Employment which averages at least 30 hours per week in a calendar month.

IRC—Internal Revenue Code (26 U.S.C.A. § § 1—1043).

Infrequent income—Income that is received not more than once in a calendar quarter.

Institutionalized spouse—The spouse who is receiving skilled care, heavy care/intermediate services or intermediate care in a nursing facility or other medical institution, including services in an ICF/MR facility, for a period likely to last for at least 30 consecutive days.

Irregular income—Income that is not subject to scheduling or is unpredictable.

LRR—Legally Responsible Relative—The spouse of a person, or the natural or adoptive parent of a child under 21 years of age.

Legal guardian—A person who is court appointed as the legal guardian.

MCCA—The Medicare Catastrophic Coverage Act of 1988 (Pub. L. 100-360, 102 Stat. 602) (July 1, 1988).

NFC—Nursing Facility Care—Skilled care, heavy care/intermediate services or intermediate care in a nursing facility or other medical institution.

Nonrecurring income—Income that is received in a single payment and not expected to continue.

Parent—The natural or adoptive father or mother of a child under 21 years of age.

Part-time employment—Employment which averages less than 30 hours per week in a calendar month.

Personal property—Privately-owned possessions. The term includes, but is not limited to, cash, bank accounts, stocks, bonds, mortgages, cash value of life insurance policies, household furnishings, personal effects, motor vehicles, boats and Federal, State and local tax refunds. The term does not include real property.

Real property—Land, buildings, mobile homes and improvements thereto.

Restricted income—Income limited by the payer for the use of a specified person.

SSI—Supplemental Security Income—The benefit amount paid to an eligible person or to an eligible person and his eligible spouse under Title XIV of the Social Security Act (42 U.S.C.A. § § 1381—1383c).

Spouse—A person who is married to another by legal ceremony or by common-law.

Unearned income—Money or other compensation received for which a service is not rendered.

The provisions of this § 181.2 adopted August 26, 1988, effective November 1, 1988, 18 Pa.B. 3949; amended August 28, 1992, effective upon publication and apply October 1, 1989, 22 Pa.B. 4432; amended July 28, 2000, the provisions under Act 20 effective retroactive to July 1, 1995, 30 Pa.B. 3779. Immediately preceding text appears at serial pages (211624) to (211625).

Notation

Authority

The provisions of this § 181.2 amended under sections 201(2) and 403(a) of the Public Welfare Code (62 P. S. § § 201(2) and 403(a)).

Notes of Decisions

Countable Net Income

Under 55 Pa. Code § § 181.101, 181.132 and this section, workers’ compensation benefits and disability insurance were properly calculated as unearned income which must be counted for purposes of Medical Assistance eligibility. Goldstein v. Department of Public Welfare, 654 A.2d 295 (Pa. Cmwlth. 1995).

Cross References

This section cited in 55 Pa. Code § 181.110 (relating to income deemed available from the spouse).