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Pennsylvania Medicaid (Medical Assistance)

Medical Assistance is the name of Pennsylvania’s Medicaid program. It provides health coverage to low-income residents, including children, pregnant women, parents, seniors, and individuals with disabilities.

Program Name Medical Assistance
Expanded Medicaid Yes
Website dhs.pa.gov
Phone 866-550-4355
Apply Online Welcome to COMPASS
Appeal a Denial Hearings and Appeals
Find a Local Office County Office Contact Information

Eligibility Requirements

To be eligible for Pennsylvania Medicaid, you must be a resident of the state of Pennsylvania, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:*

  • Pregnant
  • Be responsible for a child 17 years of age or younger
  • Have a disability or a family member in your household with a disability

* ACA Medicaid expansion covers eligible low-income adults.

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $17,131
2 $23,169
3 $29,207
4 $35,245
5 $41,284
6 $47,322
7 $53,360
8 $59,398

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Early and periodic screening Nurse midwife services
Emergency services Nursing facility services
Family planning services Outpatient hospital services
Federally qualified health center services Physician services
Home health services Prescriptions
Inpatient hospital services Rural health clinic services
Laboratory and X-ray services Tobacco cessation for pregnant women
Maternity services Transportation to medical care


Hospital stay $3/day (up to $21 for total stay)
Prescriptions (generic) $1
Prescriptions (brand name) $3
X-ray or other medical diagnostic test $1.00

For other health services, the amount of the copayment is based on the Medical Assistance fee for the service.

MA Fee for the Service Copayment
$2 – $10 $0.65
$10.01 – $25 $1.30
$25.01 – $50 $2.55
$50.01 or more $3.80

Copayments are not required for:

  • Persons younger than 18 years old.
  • Pregnant women (including the postpartum period)
  • Residents of a long-term care facility
  • Individuals receiving hospice care.
  • Women in the Breast and Cervical Cancer (BCCPT) Program
  • Individuals in the Title IV Foster Care Adoption Assistance Programs