Current through Register Vol. 54, No. 25, June 22, 2024
Section 140.221 - Conditions of eligibilityEligibility for MA under the Healthy Horizons Program is based on the following:
(1) An individual shall meet the following eligibility requirements: (i) Chapters 125 and 127 (relating to application process; and reserved).(ii) Chapter 148 (relating to residence).(iii) Chapter 149 (relating to citizenship and alienage).(iv) Chapter 155 (relating to enumeration).(v) Chapter 178 (relating to resource provisions for categorically NMP-MA and MNO-MA).(vi) Chapter 255 (relating to restitution).(vii) Chapter 257 (relating to reimbursement).(2) Under the Healthy Horizons Categorically Needy Program, an individual shall also meet one of the following criteria: (i) Be 65 years of age or older.(ii) Be a disabled person who is receiving Social Security Disability benefits or disability benefits based on SSI disability criteria at § 141.71 (relating to policy).(iii) Be a disabled person who meets the disability requirements of § 141.71.(3) Under the Healthy Horizons Medicare Cost-Sharing Program, an individual shall also be a qualified Medicare beneficiary.The provisions of this § 140.221 amended May 24, 1996, effective 5/25/1996, and apply retroactively to January 1, 1993, for the SLMB Medicare Cost-Sharing Program for persons whose income does not exceed 110% of the FPIGs, and retroactively to January 1, 1995, for persons whose income does not exceed 120% of the FPIGs, 26 Pa.B. 2412.