How to apply for Pennsylvania Medical Assistance

Last verified: June 2026

Four ways to apply for Pennsylvania Medical Assistance

What documents do you need to apply?

DHS verifies identity, residency, income, and citizenship or immigration status. Gather these before starting your application — having them ready prevents delays:

• Proof of identity: state ID, driver's license, U.S. passport, birth certificate, or similar government-issued document
• Proof of Pennsylvania residency: utility bill, lease agreement, or official mail showing your current address
• Proof of income for all household members: pay stubs (most recent 30 days), employer letter, or self-employment records
• Social Security numbers for all household members applying for coverage
• Proof of citizenship or immigration status (U.S. birth certificate, passport, naturalization certificate, or immigration documents)
• Health insurance information if any household member currently has coverage
• Medical bills if applying based on disability or a specific medical condition

If you cannot gather all documents immediately, submit your application and contact your CAO to request more time. Per DHS guidance, the agency will work with applicants to obtain needed documentation.

Interviews for Pennsylvania Medical Assistance: usually by phone

Some Medical Assistance categories — particularly those for seniors and people with disabilities — require an eligibility interview. At most Pennsylvania County Assistance Offices, this interview is conducted by phone rather than in person. You will receive a call from your CAO after submitting your application. Missing the call can delay your case, so make sure the phone number on your application is current and that you can answer calls from unknown numbers.

For MAGI-based Medical Assistance (the standard ACA expansion category), Pennsylvania typically does not require a separate interview — eligibility is determined based on the documentation submitted.

How long does the application take?

Per federal regulations at 42 CFR 435.912, states must process most Medicaid applications within 45 days of receipt. Applications based on disability must be processed within 90 days. Pennsylvania DHS follows these federal standards.

If you submit your application through COMPASS, you can track its status at trackmybenefits.pa.gov. Status updates appear there for LIHEAP, Medicaid, SNAP, and TANF applications.

Presumptive eligibility is available for pregnant women — qualified entities (hospitals, health centers, and some providers) can make a temporary eligibility determination so care can begin while the full application is pending.

What happens after your application is approved?

Once approved, you will receive a Medical Assistance ACCESS card — a plastic card similar to a debit card that serves as proof of coverage. You will also receive information about choosing a HealthChoices managed care organization if you have not already selected one. Your MCO will then be your primary contact for finding providers, requesting prior authorizations, and managing care.

• Select a HealthChoices MCO — or DHS will auto-assign one — within the enrollment window
• Register with your MCO and receive their member ID card and provider directory
• Establish care with a primary care provider in your plan's network
• Keep your COMPASS account updated with current address and phone number — DHS sends renewal notices by mail

What to expect after you submit

Under 42 CFR § 435.912, most Medical Assistance applications must be processed within 45 days. Disability-based applications have a 90-day window. You can track your application status at trackmybenefits.pa.gov.

1. 1

   Application received and date-stamped

   Your County Assistance Office records the date your application is received — this determines your potential coverage start date. Online applications submitted through COMPASS are time-stamped immediately.

2. 2

   Electronic verification

   DHS checks identity, income, and citizenship through SSA, IRS, and Pennsylvania wage records. If verification succeeds electronically, no additional documents are needed.

3. 3

   CAO contact (if needed)

   Some categories — especially disability-related applications — require a phone interview with your local CAO. Make sure the phone number on your application is correct and answer calls from DHS numbers.

4. 4

   Decision notice

   You receive a written approval or denial from your CAO. If denied, the notice states the reason and explains your right to a fair hearing within 30 days (or 10 days to preserve aid-pending benefits during the appeal).

5. 5

   ACCESS card and HealthChoices plan selection

   Approved enrollees receive a Medical Assistance ACCESS card. Select a HealthChoices managed care plan at enrollnow.net or call 1-800-692-7462. Not choosing results in auto-assignment to an available plan in your county.