Understanding Medicaid in Pennsylvania

Understanding Medicaid benefits can be confusing, especially if you’ve never enrolled in this program before. While there are many resources out there to help you get started, we’ve compiled the basics for decoding Medicaid in Pennsylvania and how you or your loved one can take advantage of these benefits.

What is Medicaid?

Medicaid is a medical assistance program for eligible Pennsylvanians. Since this program is funded by both the state and federal government, requirements differ slightly from state-to-state. This is not to be confused with Medicare, which is offered at a federal level to all citizens 65 and over.

Medicaid Eligibility in Pennsylvania

While Medicaid is often thought to be just for individuals over the age of 65, seniors are not the only citizens who are eligible. Any adult who is 19-65 and makes less than 133% of the Federal Income Poverty Guidelines can qualify, as well as individuals who are blind and disabled. There is some additional availability for families and special conditions as well.

All eligible persons must be:

• Able to prove their identity
• A citizen of the United States with a Social Security Number, a refugee or, in select circumstances, a lawfully admitted alien
• A resident of Pennsylvania

If you fall into an eligible category, your income will be assessed to determine if you qualify for benefits. Income may include, but is not limited to:

• Wages
• Social Security
• Interest
• Veteran’s Benefits
• Pensions
• Spouse’s Income

Non-income related resources may also be considered when determining your eligibility. These may include but are not limited to:

• Cash
• Checking and Savings Accounts
• Stocks
• Life Insurance
• Non-resident Property
  
  

Enrolling in Medicaid

Even if you’re unsure if you qualify for Medicaid, the best way to determine your eligibility is to apply. You can visit COMPASS to fill out an application and they’ll work with you to determine the level of Medical Assistance that you qualify for. Once you are qualified for Medicaid, if you’d like to apply some of your benefits to a service like home health care, you’ll need to fill out a PA Medicaid Waiver. If you have questions about how you can use this assistance with Comforting Home Care, you can reach out to our team for help.