Income Guidelines for Medical Assistance in Pennsylvania

If you’re looking for information on the income guidelines for medical assistance in Pennsylvania, you’ve come to the right place. In this blog post, we’ll cover everything you need to know about how your income affects your eligibility for Medical Assistance

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What is medical assistance?

Medicaid is a program that provides health care coverage for certain low- and moderate-income people and families. Medicaid is jointly funded by the federal government and the states, and each state has its own rules about who is eligible to receive Medicaid benefits.

In general, people who have low incomes and few resources may be eligible for Medicaid. Some states have expanded their Medicaid programs to cover additional groups of people, such as low-income adults without children, pregnant women, and people with disabilities.

To learn more about Medicaid eligibility in your state, visit www.healthcare.gov/lower-costs/eligibility/.

Who is eligible for medical assistance?

In order to be eligible for Medical Assistance your household income must not exceed the guidelines set forth by the Pennsylvania Department of Human Services. The following chart lists the maximum monthly income a household can earn and still qualify for medical assistance.

Household Size|Monthly Income Limit
1|$1,317
2|$1,797
3|$2,277
4|$2,757
5|$3,237
6|$3,717
7|$4,197
8|$4,677

How much income is considered low enough to qualify for medical assistance?

To be eligible for medical assistance in Pennsylvania, your household income must fall below a certain level. The exact amount varies depending on your family size and circumstances, but generally speaking, if your income is at or below 138% of the federal poverty level, you may qualify for assistance.

Income levels are updated each year to account for changes in the cost of living. For 2020, the federal poverty level is $12,490 for an individual and $25,750 for a family of four. That means that in order to qualify for medical assistance in Pennsylvania, your household income must be at or below $16,971 for an individual or $34,846 for a family of four.

If you have questions about whether you qualify for medical assistance in Pennsylvania or would like help applying for benefits, please contact your local county Office of Income Maintenance.

What are the asset limits for medical assistance?

In order to qualify for medical assistance, an individual’s countable assets must not exceed $2,000 for an individual or $3,000 for a couple. However, some assets are not counted when determining eligibility for medical assistance. These “exempt” assets include:

-One’s primary residence
-Acar
-Personal belongings
-Burial plots
-Certain annuities
-Certain trusts

How do I apply for medical assistance?

In order to apply for medical assistance, you will need to fill out an application and submit it to your local county office. You can find the application online at https://www.compass.state.pa.us/Compass.Web/ProviderEnrollment/ openings or you can pick up a paper copy at your local county office.

If you are not already enrolled in a managed care organization (MCO), you will also need to choose one when you apply for medical assistance. You can find more information about MCOs here: https://www.compass.state.pa.us/Compass.Web/ConsumerEnrollment/ ManagedCareOrganizations

Your local county office will determine if you are eligible for medical assistance based on your income, assets, and other factors. To be eligible for medical assistance, your income must be at or below the following guidelines:

*If you are single and have no children, your monthly income must be at or below $1,012 in order to qualify for medical assistance.
*If you are a family of two adults with no children, your monthly income must be at or below $1,375 in order to qualify for medical assistance

How do I know if I am approved for medical assistance?

To be approved for medical assistance, you or your household must meet certain income standards.

Your countable income must be at or below the following amounts:
* $1,384 for a single person
* $1,873 for a couple
* Add $ 485 for each additional family member

What happens if my income or assets change after I am approved for medical assistance?

If your income or assets change after you are approved for medical assistance, you must report the changes to your county assistance office. Your eligibility for medical assistance may be affected by the changes.

Some changes in income or assets may make you ineligible for medical assistance. Other changes may affect the amount of your medical assistance.

You must report the following changes:
-An increase in income
-A decrease in income
-An increase in assets
-A change in family composition (such as a divorce, marriage, birth, adoption, or placement for adoption)
-A change in living arrangements

Can I get medical assistance if I am not a Pennsylvania resident?

You may be eligible for medical assistance through the non-profit organization, Pennsylvania Health Access Network, if you are not a resident of Pennsylvania.

I am a Pennsylvania resident but I am not a U.S. citizen. Can I still get medical assistance?

Yes, you may still be eligible for medical assistance if you are a legal immigrant, have been a resident of Pennsylvania for at least five years, and meet all other program criteria.

What other programs can I get help from if I don’t qualify for medical assistance?

If you do not qualify for medical assistance, you may be able to get help from other programs.
-The Children’s health insurance Program (CHIP) provides health coverage to eligible children and pregnant women.
-If you are a senior citizen, you may be able to get help from the Senior health insurance program.
-If you have a disability, you may be able to get help from the Disability health insurance program.