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55 Pa. Code § 140.202. Definitions.

§ 140.202. Definitions.

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

   Applicant/recipient—A person who is applying for, or receiving, benefits under the Healthy Horizons Program.

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

   Countable net income—Income counted in determining income eligibility for Healthy Horizons, less appropriate exemptions, deductions and disregards.

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

   Immediate family—The child, the biological or adoptive parent of a child under 21 years of age, the spouse of the parent, and the brother, sister, step-brother, step-sister, half-brother or half-sister who are under 21 years of age. The immediate family members must be living together.

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

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

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

   Personal property—Privately owned possessions which are not real property. The term includes 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.

   QI—Qualifying individual—An individual who is enrolled in Medicare hospital insurance under Part A and meets the income requirements in §  140.231(c) or (d) (relating to income eligibility limitations) and resource requirements in §  140.301 (relating to resource eligibility limitations).

   QI-1s—Qualifying Individual-1s—A qualifying individual who meets the income requirements in §  140.231(c). Eligibility for Medicaid benefits is limited to full payment of Medicare Part B premiums.

   QI-2s—Qualifying Individual-2s—A qualifying individual who meets the income requirements in §  140.231(d). Eligibility for Medicaid benefits is limited to partial payment of Medicare Part B premiums.

   QMB—Qualified Medicare beneficiary—An individual who is entitled to, or voluntarily enrolled in, Medicare hospital insurance under Part A.

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

   SLMB—Specified low-income Medicare beneficiary—An individual who meets the eligibility requirements for QMB status except for income in excess of the QMB income limit, but not exceeding the limits specified in §  140.231.

   SSI—Supplemental Security Income—The benefit amount paid to an eligible person or to an eligible person and the eligible spouse under Title XVI 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.


   The provisions of this §  140.202 amended under sections 201(2) and 403(b) of the Public Welfare Code (62 P. S. § §  201(2) and 403(b)).


   The provisions of this §  140.202 amended May 24, 1996, effective May 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; amended December 30, 1999, effective January 1, 2000, 30 Pa.B. 15; amended June 15, 2001, effective June 16, 2001, 31 Pa.B. 3196. Immediately preceding text appears at serial pages (262298) to (262299).

Cross References

   This section cited in 55 Pa. Code §  140.305 (relating to resources of children under 21 years of age and families with children under 21 years of age).

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