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Pennsylvania Medicaid, or Medical Assistance Program

What You Need To Know

Medicaid is a program is set up to provide health coverage to those who are unable to afford it. The children, pregnant women, seniors, parents and people with disabilities are catered to diligently. Millions of Americans enjoy these benefits which help to secure their health. This health safety is provided to all low-income adults in some states. Their earnings must be below a specific level. Pennsylvania Medicaid has been administered through CMS, also known as the Center for Medicare & Medicaid Services. For this reason, it follows the rules and regulations of the Federal Medicaid Law. Medicaid can go by a lot of names, it is, therefore, known as Medical Assistance in Pennsylvania as well.

Medicaid provides you with two kinds of care, including physical health options and mental health services options. The later also includes any substance abuse services options. With the help of the federal and state government, the program is aimed at making life easier for residents. Especially those who face financial struggles at various points in their lives.

Are You Eligible?

To enjoy the benefits offered by this program, it’s important to meet the criteria set by federal and state governments. The requirements in this benefits program include factors like the following:

  • The person must be a resident of the state of Pennsylvania
  • Their financial situation should consist of low or very low income
  • They must be a U.S. national, citizen, or legal alien.
  • They must be pregnant or a parent to a child under 18
  • They must have a disability or their household members must have a disability.
  • The annual household income of the family also comes into play. The amount before tax deduction is considered which should be either less than or equal to:
Size of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

In instances where there are more than eight residents in a household, an additional amount of $5,878 is added. These guidelines may change therefore, it is vital to keep in touch with the managing agency. The one in your area may be able to provide you accurate guidance.

How To Apply?

If you wish to apply for this benefit program, there are different ways to do so. The variety allows people to easily go through the process. They can choose the best option for themselves and apply it accordingly.

  • The application for the Pennsylvania Medicaid program can be found through online portals. This includes their COMPASS application portal. In case any additional information is required, there are other websites available such as the Health Care page. On these pages, you can easily download an application.
  • In case you wish to apply by having direct contact with the center, you can simply call on their Telephone which is 1-866-550-4355.
  • Some people find it more comfortable to tackle these applications in person. Therefore, Pennsylvania has set up local county assistance offices throughout the state. Contacting them is a simple method.
  • Along with these ways, there is also a written method to apply. The application form is available on specific sites. Therefore, it can be downloaded, filled and mailed to the appropriate authority.

These applications require information and documentation that can be easily verified. With limited resources, the people that can be catered to are limited too. Therefore, the eligibility criteria are strictly followed in order to make sure the more needy families are catered to. So far, the Pennsylvania Medicaid program has helped around three million people. This is a huge amount which the program wishes to expand further. The decision for qualified individuals is taken by none other than the DHS.

For Further Information

To deal with the queries one has, they can also contact the appropriate authority. This can be done by visiting the Medicaid and CHIP page which has the policies stated. These policies can be found according to the state.

In-depth information about the Pennsylvania Medical Assistance is necessary for its residents. Especially those that are hoping to gain benefit from it. This knowledge is important for the residents as proper information can make them more likely to receive benefits.  Pennsylvania has also introduced other programs that can cover those applicants who don’t qualify for Medicaid. This includes the Children’s Health Insurance Program (CHIP) and Medical Assistance for Workers with Disabilities (MAWDs). These programs help to cater to a majority of the Pennsylvanian population. Thus, it helps the program to achieve the objective that it had set out for.



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