Pennsylvania’s Medical Assistance Income Limits for 2017

Find out if you qualify for Pennsylvania’s Medical Assistance program by learning about the income limits for 2017.

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Introduction

Medicaid is a joint federal and state program that helps with medical costs for some people who have limited income and resources. Medicaid coverage is different in every state.

In Pennsylvania, the program is called Medical Assistance (MA). To be eligible for MA, you must meet certain income and resource standards. These standards are different if you are age 65 or over, disabled, pregnant, or under age 21.

What are the income limits for Pennsylvania’s Medical Assistance program in 2017?

Medical Assistance is Pennsylvania’s Medicaid program. It provides health care coverage for low-income adults, children, pregnant women, people with disabilities, and seniors.

To be eligible for Medical Assistance, your income must be below a certain level. The income limits vary depending on your family size.

In 2017, the income limits for a family of one are $16,394 for an individual and $22,108 for a couple. For a family of two, the limits are $22,108 for an individual and $29,819 for a couple. For a family of three, the limits are $27,824 for an individual and $38,346 for a couple.

If you have more than three people in your family, the income limits increase by $4,522 for each additional person.

In addition to meeting the income requirements, you must also be a resident of Pennsylvania and a U.S. Citizen or legal immigrant to be eligible for Medical Assistance.

How are the income limits calculated?

Pennsylvania’s Medical Assistance (Medicaid) income limits for 2017 were calculated using the Federal Poverty Level (FPL) guidelines. The FPL is adjusted each year to account for inflation. The 2017 poverty guidelines are available here.

To calculate the income limits for Medicaid, Pennsylvania uses the Modified Adjusted Gross Income (MAGI) methodology. MAGI is defined as your household’s taxable income, plus any untaxed foreign income, Social Security benefits, and certain tax-exempt interest income.

The income limits for Medicaid in Pennsylvania are as follows:

Family Size* Maximum Income Limit (FPL)
1 $16,642
2 $22,412
3 $28,182
4 $33,952
5 $39,722
6 $45,492
7 $51,262
8 $57,032

What are the assets limits for Pennsylvania’s Medical Assistance program in 2017?

In order to be eligible for Pennsylvania’s Medical Assistance program, your household income must fall below certain limits. These limits vary depending on the size of your household. For a family of four, the income limit is $4,537 per month. If you are single and have no dependents, the income limit is $1,012 per month.

How are the assets limits calculated?

Pennsylvania’s Medical Assistance (MA) program has income and asset limits for eligibility. The income limit is different if you are applying as an individual or as a family. The asset limit is the same for both, however.

To calculate your assets, add up the value of everything you own including:
-Cash
-Checking and savings accounts
-Property (other than your home)
-Stocks and bonds
-Businesses you own

Your home is not counted as an asset, but there are limits on the value of your home if you plan to sell it and use the proceeds to pay for long-term care. If you are over the asset limit, you may still be eligible for MA if you spend down your assets to meet the limit.

What other factors are considered when determining eligibility for Medical Assistance in Pennsylvania?

In addition to household size and gross income, the following factors are considered when determining eligibility for Medical Assistance in Pennsylvania:

-Age
-Disability
-Pregnancy
-Parental status
-Resources

How often are the income and asset limits updated?

Income and asset limits for Pennsylvania’s Medical Assistance program are updated annually.

What happens if my income or assets exceed the limits?

If your income or assets (including cash, savings, stocks, bonds, real estate) exceed the limits above, you cannot get Pennsylvania’s Medical Assistance. But, you may be able to buy into Medical Assistance by paying a monthly premium. The premium is based on your income. You must apply for Medical Assistance and pay the first month’s premium before your medical coverage can begin.

Can I appeal if I am denied Medical Assistance?

If you are denied Medical Assistance, you have the right to appeal. You can ask for a hearing with a PA Department of Human Services hearing officer, or you can have your case reviewed by an independent organization called the Office of Hearings and Appeals.

Where can I get more information about Medical Assistance in Pennsylvania?

To find out more about Medical Assistance in Pennsylvania, including information on income limits, visit the Pennsylvania Department of Human Services website.

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