RIGHT TO APPEAL AND FAIR HEARING

§ 140.791. Appeal and fair hearing.

 The applicant or recipient is entitled to the appeal and fair hearing rights under Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings).

APPENDIX A

EXTENDED MEDICAL COVERAGE (EMC)
MONTHLY INCOME LIMITS
185% OF THE 2013 FEDERAL POVERTY INCOME
GUIDELINES

Family Size	185% of the Federal Poverty Income Guidelines
1	$1,772
2	$2,392
3	$3,011
4	$3,631
5	$4,251
6	$4,871
7	$5,490
8	$6,110
Each Additional Person	$620

Source

   The provisions of this Appendix A adopted October 16, 1992, effective upon publication and apply retroactively to April 1, 1990, 22 Pa.B. 5164; amended July 2, 1993, effective February 12, 1993, 23 Pa.B. 3168; amended April 15, 1994, effective upon publication and apply retroactively to February 10, 1994, 24 Pa.B. 1972; amended August 25, 1995, effective August 26, 1995, and apply retroactively to February 9, 1995, 25 Pa.B. 3490; amended May 10, 1996, effective upon publication and apply retroactively to March 4, 1996, 26 Pa.B. 2213; amended July 3, 1997, effective March 10, 1997, 27 Pa.B. 3235; amended November 6, 1998, effective November 7, 1998, and apply retroactively to February 24, 1998, 28 Pa.B. 5628; amended April 26, 2002, effective and apply retroactively to February 14, 2002, 32 Pa.B. 2165; amended May 2, 2003, effective retroactively to February 7, 2003, 33 Pa.B. 2227; amended May 14, 2004, effective retroactively to February 13, 2004, 34 Pa.B. 2645; amended April 28, 2006, effective January 24, 2006, 36 Pa.B. 2072; amended May 4, 2007, effective May 5, 2007, 37 Pa.B. 2158; amended April 4, 2008, effective retroactively to January 23, 2008, 38 Pa.B. 1644; amended May 22, 2009, effective retroactively to January 23, 2009, 39 Pa.B. 2648; amended April 15, 2011, effective retroactively to January 20, 2011, 41 Pa.B. 2095; amended May 24, 2013, effective retroactively to January 24, 2013, 43 Pa.B. 2967. Immediately preceding text appears at serial page (356551).

Cross References

   This appendix cited in 55 Pa. Code §  140.431 (relating to income eligibility limits).

APPENDIX B

MEDICAID FOR CHILDREN WITH SPECIAL NEEDS MONTHLY PREMIUM CHART

Family Size
Parents Annual Income At least—Less Than	2	3	4	5	6	7	8	Each Additional member
$0-$39,999.99	NO PREMIUM IF INCOME BELOW 200% FPIG
$40-$49,999.99	$30	$29	$27	$26	$24	$0	$0	$0
$50-$59,999.99	$40	$38	$36	$34	$33	$31	$0	$0
$60-$69,999.99	$50	$48	$45	$43	$41	$39	$37	$0
$70-$79,999.99	$60	$57	$54	$51	$49	$46	$43	$0
$80-$89,999.99	$75	$71	$68	$64	$61	$58	$55	(-$3)
$90-$99,999.99	$100	$95	$90	$86	$81	$77	$73	(-$4)
$100-$109,999.99	$150	$143	$135	$129	$122	$116	$111	(-$5)
$110-$119,999.99	$200	$190	$181	$171	$163	$155	$148	(-$7)
$120-$129,999.99	$250	$238	$226	$214	$204	$193	$185	(-$8)
$130-$139,999.99	$300	$285	$271	$257	$244	$232	$222	(-$10)
$140-$149,999.99	$350	$333	$316	$300	$285	$271	$259	(-$12)
$150-$159,999.99	$400	$380	$361	$343	$326	$310	$297	(-$13)
$160-$169,999.99	$475	$451	$429	$407	$387	$368	$352	(-$16)
$170-$179,999.99	$600	$570	$542	$514	$489	$464	$442	(-$22)
$180-$189,999.99	$675	$641	$609	$579	$550	$522	$497	(-$25)
$190-$199,999.99	$800	$760	$722	$686	$652	$619	$588	(-$31)
$200-$249,999.99	$925	$879	$835	$793	$753	$716	$679	(-$37)
$250-$299,999.99	$1,000	$950	$903	$857	$815	$774	$739	(-$35)
$300-$349,999.99	$1,000	$950	$903	$857	$815	$774	$739	(-$35)
$350-$399,999.99	$1,000	$950	$903	$857	$815	$774	$739	(-$35)
$400-$449.999.00	$1,000	$950	$903	$857	$815	$774	$739	(-$35)
$450-$499,999.99	$1,000	$950	$903	$857	$815	$774	$739	(-$35)
$500,000 +	$1,000	$950	$903	$857	$815	$774	$739	(-$35)

Source

   The provisions of this Appendix B adopted December 30, 2005, effective upon receipt of written notification that the United States Department of Health and Human Services has granted the waiver requested by the Department under section 1115 of the Social Security Act, the Department will publish notice thereof in the Pennsylvania Bulletin. The regulations adopted by this order become effective 30 days after receipt of the Federal waiver, 35 Pa.B. 7013.

Cross References

   This appendix is cited in 55 Pa. Code §  140.604 (relating to premiums).

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