Resources & 2026 eligibility limits

Reference figures for 2026 (federal and Pennsylvania). These are informational ceilings only — SSA, PA DHS, and your county assistance office make the actual eligibility determinations. Always confirm with a benefits counselor before acting.

Reporting clocks differ by program. Your renewal date is only one deadline. Some benefits also require reports between renewals or prompt notice when your circumstances change. Bene-Watch helps you track each obligation separately. SSI financial changes are due by the 10th of the next month, and a disability review is a different notice. SSDI and DAC work reports are prompt. Medicaid financial renewals, waiver service reviews, and QMB renewals are separate. Extra Help is deemed while Medicaid, SSI, or QMB continues. SNAP ordinary SAR households file PA 564 between recertifications. Elderly or disabled households with earned income still have interim reports on a 24-month certification. ESAP households with no earned income do not file PA 564. Disability alone is not an exemption.

Social Security (SSDI / DAC)

SSDI — Substantial Gainful Activity (SGA), non-blind$1,690 / moGross earned income only. Earning above this (after the Trial Work Period / EPE) can end SSDI cash benefits.
DAC (Disabled Adult Child)No earned-income capDisability must have begun before age 22; recipient generally unmarried; parent on SS/SSDI or deceased. SGA still governs whether the disability is considered ongoing.

Medicare Part D Extra Help (LIS) — 2026

Monthly income$2,015 / moOne person. A couple must be below $2,725. The $20 disregard is already included. Reaching the limit does not qualify.
Resource (asset) limit$18,090One person. A couple must be below $36,100. Automatic with Medicaid, QMB, or SSI.

Pennsylvania Medicaid & Waiver — 2026

HCBS / CHC Waiver — income$2,982 / moGross countable income. Equal to $2,982 still qualifies. Not used when the person receives SSI. A DAC benefit is left out.
HCBS / CHC Waiver — assets$8,000One person: $2,000 plus a $6,000 disregard. Not used on SSI. A married couple's protected share is set at assessment.
MAGI Medicaid — assetsNo asset testAdults 19–64: $1,836 a month for one person, $2,489 for two. Income equal to the limit still qualifies. Not used when the person receives SSI.
Full Medicaid (ABD / Healthy Horizons) — income$1,330 / moOne person. Two is $1,804. SSI-countable income. The SSI payment and a DAC benefit are left out. SSDI counts.
Full Medicaid (ABD) — assets$2,000$3,000 for two or more. $8,000 if Medicaid was entered through a waiver. Not tested under age 21.
MAWD (Workers with Disabilities) — countable income$3,325 / moOne person. Two is $4,509. Countable income, not a gross paycheck. Workers with Job Success uses 600% ($7,980 for one person).
MAWD — assets$10,000Any household size. Exactly at $10,000 still qualifies. No asset cap once Workers with Job Success is recorded.
QMB (Medicare Savings) — income$1,350 / moOne person. A couple is $1,824. The $20 disregard is already included. Income equal to the limit still qualifies.
QMB — resources$9,950One person. A couple is $14,910. Exactly at the limit still qualifies.

Pennsylvania SNAP — gross monthly income (200% FPL), 2025–2026

Household of 1$2,610 / mo
Household of 2$3,534 / mo
Household of 3$4,458 / mo
Household of 4$5,360 / mo
Household of 5$6,284 / mo
Household of 6$7,208 / moAdd ~$924 per additional person.
Resource limit$4,250Only if the household has an elderly/disabled member and fails the gross-income test; otherwise no asset limit.

SSI & Special Needs Trust distributions — 2026

SSI Federal Benefit Rate (FBR)$994 / moIndividual ($1,491 for an eligible couple). SSI pays the FBR minus countable income.
SNT cash into a personal bank accountCountsFor SSI, money inside a qualifying SNT is usually excluded as a resource. Cash deposited to checking or savings is generally unearned income that month. This SSI treatment is not a rule for every other program.
Shelter paid to a vendor (ISM)Capped ~$331 / moRent, mortgage, property tax, gas, electric, water. Counted at the Presumed Maximum Value (PMV = ⅓ FBR + $20 ≈ $351.33), so a $1,500 rent payment lowers the check by only ~$331.33 — leaving ~$662.67 plus fully-paid housing.
Food / non-shelter paid to a vendor$0 impactFor SSI, food and many non-shelter vendor payments have been outside in-kind support since Sept 30, 2024 (89 FR 21246). That does not decide Medicaid or other programs, and it does not make every vendor payment benefit-safe.

Effect of payments coming from an SNT — 2026

An estimate of how one trust distribution might affect the monthly SSI check. It is not a determination, and it does not apply automatically to Medicaid or other programs. Cash paid to the beneficiary is generally treated differently from many direct vendor payments, and some direct shelter payments can still affect SSI. Real cases also turn on living arrangement, deeming, and any state supplement.

Estimated SSI check this month

$662.67

Federal Benefit Rate
$994.00
Counted as income
$351.33
Reduction from this payment
− $331.33
Presumed Maximum Value (cap)
$351.33

Shelter paid directly to a vendor (rent, mortgage, property tax, gas, electric, water) is In-Kind Support & Maintenance, counted at no more than the Presumed Maximum Value — so the reduction is capped, not dollar-for-dollar.

Remember the formula, not the figure: PMV = (⅓ × FBR) + $20. Only the FBR changes each January with the COLA, and the cap follows from it. These figures illustrate SSI only. Cash paid to the beneficiary is generally treated differently from many direct vendor payments, and some direct shelter payments can still reduce the SSI check. Other programs follow their own rules. Bene-Watch does not decide whether a trust payment is permissible or whether it affects eligibility.

Note: SNT (Special Needs Trust) and ABLE account balances are excluded from countable assets across these programs — separate from the income rules above, which govern how trust payments affect the monthly SSI check.

2026–2027 policy screen

SNAP work-rule expansion, MAGI hours, and immigrant-category restrictions from the market-strategy deck. Every rule is unverified until Pennsylvania’s effective date, waivers, and notice language are confirmed. This is not a compliance determination.

Not verified as Pennsylvania law yet — do not treat this as a current requirement

Answer age and household questions to see whether the expanded SNAP rule could apply

The deck describes late-2025 expansion to older adults up to age 65, caregivers of children 14+, and removal of veteran and former foster-youth exemptions. Confirm PA’s effective date, waivers, and age cutoffs before treating anyone as noncompliant.

Documents if this rule ever applies

  • Birth record or ID showing age
  • Child’s birth record and school/childcare schedule if claiming caregiving
  • Clinician statement on ability to work
  • Monthly activity proof (pay stubs, timesheets, program attendance)
  • Any SNAP employment-and-training assignment
What to do
1. Threatened program
SNAP
2. Triggering rule
Losing disability status, dropping required hours, a child turning 14, aging into a new work-rule band, or a repealed exemption (veteran / former foster youth, as described in the 2025–26 policy deck) can expose the household to time limits.
3. Deadline / effective date
First confirm the rule is in effect for this person, category, and certification period. 2026–2027 policy dates, Pennsylvania waivers, exemptions, and delayed starts must be verified before treating a projected rule as current law.
4. Action that cures or limits the loss
Verify the current Pennsylvania rule and effective date. Screen every remaining exemption and good cause before treating the person as noncompliant. If no exemption applies, document qualifying activity each required period.
5. Documents
  • Current pay stubs or benefit award letters
  • Bank statements covering the month in question
  • Any DHS/SSA notice and proof of what was already submitted
6. If this category cannot continue
Screen for another Medicaid category (including MAWD or a waiver), a Medicare Savings Program, Marketplace coverage, or SNAP adjustments before the current benefit ends.
7. Appeal / continued benefits
If an adverse notice has already issued, appeal by the date on that notice. Request continued cash, medical coverage, or services by any shorter continuation deadline on the same notice — it is often earlier than the appeal deadline. File a new application in parallel if reopening is uncertain.

Step-by-step plan

  1. Verify the current effective rule, covered age range, certification period, and whether Pennsylvania has any applicable waiver or implementation exception.
  2. Screen for a medical-unfitness or disability exemption even if he does not receive disability benefits. Obtain a clinician's statement addressing his ability to work.
  3. Screen for other exemptions, including qualifying caregiving, pregnancy, participation in another recognized program, or another exemption in current guidance.
  4. If no exemption applies, create a documented plan for the required paid work, self-employment, approved training, community service, or permitted combination of activities.
  5. Submit proof each required period and retain time sheets, employer letters, program attendance records, and submission confirmations.
  6. Appeal any termination that applies the wrong age, ignores a waiver or exemption, or counts qualifying activity incorrectly; reapply promptly when compliance or exemption status is established.

DHS closure codes

  • 440. Semi-Annual Reporting Requirements Not Met — a procedural label on a budget/case action, not necessarily a unique person or permanent loss.
  • 474. SNAP End of Certification Period — the budget closed because the certification period ended. It does not by itself prove a missed renewal, household fault, or substantive ineligibility.

Informational only — Bene-Watch does not determine eligibility. Confirm with SSA, the County Assistance Office, COMPASS, or a qualified benefits counselor.

The salary and trust examples below are SSI illustrations. They are not a determination, and they do not apply automatically to Medicaid, SNAP, or another program.

Salary increase + SNT disbursement — reporting scenarios

Wage changes and trust payouts interact. Pick a scenario to see SSI vs SSDI impact and the reporting steps for SSA and COMPASS/CAO. Informational only.

1. Salary increase only (no SNT payout this month)

Gross wages go up. No Special Needs Trust distribution in the same month.

SSI impact

Countable earned income = (gross − $85) ÷ 2. Higher wages lower the SSI check on the sliding scale; they do not create ISM.

SSDI / DAC impact

Watch SGA ($1,690/mo non-blind, 2026) and TWP service months ($1,210/mo). After 9 TWP months, SGA can zero the SSDI check.

Reporting steps

  1. Report the wage change to SSA (SSI and/or SSDI/DAC) by the 10th of the month after the change month.
  2. Report to COMPASS / County Assistance Office for Medicaid, Waiver, SNAP, and QMB if enrolled.
  3. File gross pay stubs (not just deposit dates) — bank deposits alone understate overtime and miss pre-tax deductions timing.

File in Vault

  • Job & income — pay stubs
  • Work & activity — hours if MAGI work rules may apply

Work and income planner

Model one month of gross wages against SSI, SSDI TWP/SGA, SNAP, MAWD, and Medicaid categories before hours change. Informational only — IRWEs, household size, and MAGI tax rules can change the real result.

30 beneficiary eligibility-loss scenarios

Prevention examples for product design and beneficiary education. Each alert is an action plan: threatened program, triggering rule, documents, next category, and appeal / continued- benefit deadlines. These are not claims that every DHS closure was avoidable, and they are not individual eligibility determinations. Final 2026–2027 policy dates must be verified before giving case-specific instructions.

DHS closure codes (clarified)

A closure-code entry is a recorded benefit-budget/case action, not necessarily a unique person or permanent loss.

  • 042. Failure to Furnish Required Information — a recorded case action, not proof of who caused the failure or that the person was substantively ineligible.
  • 440. Semi-Annual Reporting Requirements Not Met — a procedural label on a budget/case action, not necessarily a unique person or permanent loss.
  • 474. SNAP End of Certification Period — the budget closed because the certification period ended. It does not by itself prove a missed renewal, household fault, or substantive ineligibility.

1 · Procedural and administrative

Elena — Medicaid renewal never completed

Benefits: MedicaidABD, MedicaidMAGI, SNAP

Trigger. Elena remains financially eligible but sets aside her Medicaid renewal because she believes coverage renews automatically.

Likely consequence. Medicaid may close for failure to complete the renewal even though she still meets the substantive rules. SNAP may remain open on a different certification schedule.

Classification. Purely procedural renewal failure.

Exact options to prevent or cure the loss

  1. Open COMPASS and every mailed notice immediately. Confirm the exact renewal due date, case number, requested verifications, and whether the renewal is still open online.
  2. Submit the signed renewal and all requested proof before the deadline. Save the confirmation page, upload receipts, and keep a complete copy.
  3. Call the County Assistance Office after submission and ask the worker to identify any missing or illegible item. Record the worker's name, date, time, and instructions.
  4. If the due date passed but the case remains open, submit the renewal immediately and ask that it be processed as a late renewal rather than waiting for closure.
  5. If coverage already closed for a procedural reason, ask for reconsideration under the applicable post-closure period and file a new application if the agency will not reopen it.
  6. Appeal by the deadline on the adverse notice and request continued benefits within any shorter continuation period. At the same time, screen for another Medicaid category or temporary replacement coverage.

Auto-detected from account activity (29)

Limit-based cliffs evaluated from linked wages and balances. 11 additional reference warnings can be opted into under Settings → alert types.

Live monitoring

ScenarioTypeProgramsRisk
SSDI cash cliff after Trial Work PeriodCliffSSDIAfter nine Trial Work Period months are recorded, gross earnings at or above SGA ($1,690/mo non-blind, 2026) can suspend the SSDI check for that month. Impairment-related work expenses and a subsidy can still bring countable earnings under SGA.
Trial Work Period service monthCliffSSDIGross earnings of $1,210 or more (2026) count as a Trial Work Period service month, including a month at or above SGA. SSDI cash continues until nine service months are recorded. Work expenses and a subsidy can bring countable earnings under the line. A stored count of zero means none are recorded yet.
DAC — earnings threaten disability statusCliffDACDAC has no trial work period and no separate wage cap. Estimated gross earnings at or above SGA ($1,690/mo non-blind, 2026) can end the disability finding and stop DAC. Work expenses and a subsidy can still bring countable earnings under SGA. The blind SGA figure is not used until statutory blindness is recorded.
SSI cash reduced to $0 near FBRCliffSSIWhen countable income reaches the Federal Benefit Rate ($994 individual or $1,491 couple, 2026), the SSI check falls to $0. The SSI payment itself is not counted as that income.
SSI resource limit ($2,000 individual / $3,000 couple)CliffSSICountable resources over $2,000 ($3,000 for an eligible couple) can suspend SSI. Being exactly at the limit does not. Home, one car, a properly structured SNT, and ABLE are usually excluded.
SNT cash paid to the beneficiarySNTSSICash from an SNT is unearned income — dollar-for-dollar after the $20 general exclusion.
ABLE balance over $100,000ABLESSI, ABLESSI cash suspends while ABLE countable cash exceeds $100,000; Medicaid can continue.
Age-18 SSI adult redeterminationCliffSSIAt 18, SSA applies the adult disability standard. Losing SSI can also end J-category Medicaid.
Student earned-income exclusion endsCliffSSIStudent Earned Income Exclusion (up to $2,410/mo / $9,730/yr in 2026) ends when the student turns 22 or leaves school.
ABD / Healthy Horizons income limitCliffMedicaidABDHealthy Horizons income is 100% of the poverty guideline for the household: $1,330 for one person, $1,804 for two, then $2,277, $2,750, $3,224, and $3,697. The test uses SSI-countable income. The SSI payment and a DAC benefit are left out. SSDI still counts.
ABD Medicaid resource limitCliffMedicaidABDThe resource limit is $2,000 for one person and $3,000 for two or more. A waiver case uses $8,000. Exactly at the limit still qualifies. This test does not apply when the person is under 21.
HCBS / CHC Waiver income ceilingCliffMedicaidWaiverThe 2026 waiver special income limit is $2,982 a month, 300% of the SSI rate. Income equal to $2,982 still qualifies. The test is gross countable income: wages and SSDI count, and a DAC benefit is left out. This limit is not used when the person receives SSI.
HCBS / CHC waiver resource limitCliffMedicaidWaiverThe waiver resource limit is $8,000 for one person: the $2,000 limit plus a $6,000 disregard. Exactly at $8,000 still qualifies. This limit is not used when the person receives SSI. A married couple’s protected share is set at the waiver assessment and is not this $8,000 figure.
SSDI lost, Waiver still safe (twilight zone)CliffSSDI, MedicaidWaiverEarnings at SGA can suspend SSDI cash after nine recorded Trial Work Period months, or can end a DAC disability finding with no trial work period, while income is still under the $2,982 waiver limit.
MAWD safety net when workingCliffMedicaidABD, MedicaidWaiver, MAWDMAWD allows higher income (250% FPL ≈ $3,325; up to 600% FPL after 12 months on Job Success) but requires paid work and a premium.
MAWD countable income limitCliffMAWDMAWD countable income is 250% of the poverty guideline: $3,325 for one person and $4,509 for two. Workers with Job Success uses 600%: $7,980 for one person and $10,820 for two. This is countable income, not a gross paycheck.
MAWD resource limitCliffMAWDCountable resources must be $10,000 or less, for any household size. Exactly at $10,000 still qualifies. Once Workers with Job Success is recorded, assets are no longer capped at $10,000.
MAGI Medicaid income limitCliffMedicaidMAGIHealthChoices for adults age 19–64 is 138% of the poverty guideline: $1,836 a month for one person and $2,489 for two. Income equal to the limit still qualifies. There is no asset test. This limit is not used when the person receives SSI.
QMB income limitCliffQMBThe 2026 QMB income limit is $1,350 a month for one person and $1,824 for a couple. That figure already includes the $20 disregard. Income equal to the limit still qualifies. QMB pays Medicare premiums and cost-sharing. It is separate from full Medicaid.
QMB resource limitCliffQMBThe 2026 QMB resource limit is $9,950 for one person and $14,910 for a couple. Exactly at the limit still qualifies. SSDI has no asset test, and that does not carry over to QMB.
Medicare Extra Help income limitCliffExtraHelp2026 Extra Help income must be below $2,015 a month for one person and below $2,725 for a couple. That figure already includes the $20 disregard. SSDI, a DAC benefit, and wages count. Someone with Medicaid, QMB, or SSI gets Extra Help automatically.
Medicare Extra Help resource limitCliffExtraHelp2026 Extra Help resources must be below $18,090 for one person and below $36,100 for a couple. Those amounts include the burial allowance. Someone with Medicaid, QMB, or SSI gets Extra Help automatically.
SNAP income over 130% FPLReportingSNAPUnder simplified reporting, gross income over 130% of the poverty line for the household size is a 10-day report. Income exactly on the line waits for the semi-annual report.
SNAP resources after the 200% gross testCliffSNAPMost households at or under 200% FPL have no SNAP resource test. $4,750 applies when a member is age 60 or older, or disabled, and gross income is already over the household's 200% line.
SNAP substantial gambling or lottery winningsReportingSNAPLottery or gambling winnings of $4,750 or more from a single game must be reported and can end SNAP for every household, including one that is otherwise under 200% FPL.
Wage change — reporting clockReportingSSI, SSDI, DAC, MedicaidABD, MedicaidMAGI, MedicaidWaiver, MAWD, SNAP, QMB, ExtraHelpA new job, a raise, a pay cut, or stopped work can be reportable. SNAP simplified reporting does not require an ordinary raise that stays under 130% FPL.
Lump-sum / inheritance / settlementReportingSSI, MedicaidABDA lump sum is income in the month it arrives. Money still held the next month is a resource, and it can put the total over $2,000 for one person or $3,000 for two or more.
Overpayment from late reportingReportingSSI, SSDI, DAC, MedicaidABD, MedicaidMAGI, MedicaidWaiver, MAWD, SNAP, QMB, ExtraHelpA reporting deadline on the calendar has passed and is still open. Late reports commonly create overpayment demands even when the person remains eligible after recalculation.
1619(b) — Medicaid while SSI cash is $0CliffSSI, MedicaidABDWhen earned income zeros the SSI check, 1619(b) can keep Medicaid if other 1619(b) tests are met — losing SSI cash is not automatically losing medical coverage.

Official program links