Pennsylvania’s Medical Assistance Program

The Pennsylvania Medical Assistance Program provides health insurance to low-income residents of the state. It is a vital resource for many people, and we want to make sure you have all the information you need to make the most of it.

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Introduction to Pennsylvania’s Medical Assistance Program

The Pennsylvania Medical Assistance (Medicaid) program pays for health care services for eligible low-income residents. Programs and services include inpatient and outpatient hospital care, physician services, laboratory and x-ray services, Home Health Care nursing home care early and periodic screening, diagnostic and treatment (EPSDT) services for children under age 21, family planning services, and dental services for adults.

In order to be eligible for medical assistance, an individual must meet certain financial criteria as well as reside in the state of Pennsylvania. To learn more about the program and how to apply, please visit the Pennsylvania Department of Human Services’ website.

Eligibility requirements for Pennsylvania’s Medical Assistance Program

In order to be eligible for Pennsylvania’s Medical Assistance Program, also known as Medicaid, applicants must meet certain income and asset requirements.

Income requirements vary depending on the size of the applicant’s household and whether the applicant is applying for themselves or for a child. For example, as of 2019, a single applicant cannot make more than $16,750 per year in order to be eligible for Medicaid. However, an applicant with a family of four can make up to $34,638 per year and still be eligible.

Asset requirements are also different depending on the size of the applicant’s household. For example, as of 2019, a single applicant cannot have more than $2,000 in assets in order to be eligible for Medicaid. However, an applicant with a family of four can have up to $5,500 in assets and still be eligible.

Applicants who do not meet these income or asset requirements may still be eligible for Medicaid if they are pregnant, disabled, elderly, or blind.

How to apply for Pennsylvania’s Medical Assistance Program

Pennsylvania’s Medical Assistance program provides health care coverage for low-income adults, children, pregnant women, people with disabilities, and the elderly. If you are a Pennsylvania resident and meet the program’s income guidelines, you may be eligible for coverage.

There are several ways to apply for Pennsylvania’s Medical Assistance program. You can apply online through the Pennsylvania Department of Human Services’ COMPASS website, by mail, or in person at your local county office.

If you are applying for Medical Assistance for yourself or your family, you will need to provide information about your household income and assets. You will also need to provide proof of Pennsylvania residency, such as a driver’s license or utility bill.

If you are eligible for coverage, you will be able to enroll in a health insurance plan through the Medical Assistance program. You will be responsible for paying a monthly premium, as well as any deductibles and copayments required by your plan.

What services are covered under Pennsylvania’s Medical Assistance Program?

Covered services under Pennsylvania’s Medical Assistance Program include, but are not limited to: inpatient and outpatient hospital care, physician services, dental services, eyeglasses, Home health care laboratory and X-ray services, long-term care, and more.

How to renew Pennsylvania’s Medical Assistance Program

In order to renew your Pennsylvania Medical Assistance program, you must first log in to the Renewal System. You will then be prompted to answer some questions about your current health insurance coverage, income, and whether or not you have any changes in your household size. After you have completed the questions, you will be able to submit your renewal request.

How to appeal a decision related to Pennsylvania’s Medical Assistance Program

If you are dissatisfied with a decision related to your Pennsylvania Medical Assistance program, you have the right to file an appeal. An appeal is a request for the Office of Hearings and Appeals to review your case.

You must file your appeal within 90 days of receiving the notice of the decision you are appealing. To file an appeal, you must complete and submit an Appeal Form (PA-500). The Appeal Form is available on the Pennsylvania Department of Human Services website or by calling 1-800-600-4213.

After you have submitted your Appeal Form, a member of the Office of Hearings and Appeals will review your case and make a decision. You will be notified of the decision in writing.

What are the income guidelines for Pennsylvania’s Medical Assistance Program?

In order to qualify for Pennsylvania’s Medical Assistance Program, your income must be at or below certain guidelines. These guidelines are based on the Federal Poverty Level (FPL).

For example, as of 2021, a single person can have an annual income of up to $17,775 and still qualify for Pennsylvania’s Medical Assistance Program. A family of four can have an annual income of up to $36,375 and still qualify.

To see the income guidelines for Pennsylvania’s Medical Assistance Program in 2021, please visit this website:

[Income Guidelines for Pennsylvania’s Medical Assistance Program](https://www.healthcare.gov/income-and-household-information/pennsylvania-income-guidelines/)

How often do I need to renew my Pennsylvania Medical Assistance Program?

You will need to renew your Pennsylvania Medical Assistance Program every 12 months.

Where can I get more information about Pennsylvania’s Medical Assistance Program?

You can get more information about Pennsylvania’s Medical Assistance Program by contacting your local county assistance office or the Pennsylvania Department of Human Services.