Pennsylvania Medicaid Eligibility Requirements

This page provides general guidelines for the Pennsylvania Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is Pennsylvania Department of Public Welfare. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the Pennsylvania Medicaid office.


Pennsylvania Medicaid Overview

Medicaid is a program for Pennsylvania residents who can't afford to pay for medical care.


Pennsylvania Medicaid Eligibility Requirements - Non Income

Must be a U.S. citizen or a qualified alien and a Pennsylvania resident.


Documents Needed For Pennsylvania Medicaid Application

  • Proof of Household Income
  • Social Security Numbers and Birth Dates of All Household Members Applying for Coverage
  • Information on Current or Recent Health Insurance
  • Car Insurance Information (If you own a car)
  • Housing and Utility Expense Information
  • Proof of Assets
  • Proof of Citizenship

Pennsylvania Medicaid Benefits

Office visits, prescription drugs, immunizations, vision testing and eye glasses, emergency room care, lab testing, x-rays, hearing testing and hearing aids, and mental and substance abuse treatment.


Pennsylvania Medicaid & CHIP Eligibility Levels

Below is the modified adjusted gross income (MAGI) eligibility levels for Pennsylvania Medicaid and Children's Health Insurance Program (CHIP).

Eligibility Levels - By Percentage Of Federal Poverty Level (FPL)

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: 215%
Age 1-5: 157%
Age 6-18: 133%
 314% Medicaid: 215%
CHIP: N/A		 33% 0%

Eligibility Levels - Individual By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $2,091
Age 1-5: $1,527
Age 6-18: $1,293
 $3,054 Medicaid: N/A
CHIP: N/A		 $321 $0

Eligibility Levels - Family Of Two By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $2,818
Age 1-5: $2,058
Age 6-18: $1,743
 $4,116 Medicaid: $2,818
CHIP: N/A		 $433 $0

Eligibility Levels - Family Of Three By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $3,546
Age 1-5: $2,589
Age 6-18: $2,193
 $5,178 Medicaid: $3,546
CHIP: N/A		 $544 $0

Eligibility Levels - Family Of Four By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $4,273
Age 1-5: $3,120
Age 6-18: $2,643
 $6,241 Medicaid: $4,273
CHIP: N/A		 $656 $0

Medicaid Eligibility

State Medicaid Office

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