Medical Assistance (MA) in Pennsylvania

Medical Assistance (MA) is Pennsylvania's Medicaid program — free or low-cost health coverage for low-income residents. It is administered by the Pennsylvania Department of Human Services.

Who qualifies for Medical Assistance (MA)?

Pennsylvania covers adults 19–64 with income up to 138% of the Federal Poverty Level (FPL). Key qualifying groups include:

• Adults (19–64): Income up to 138% FPL (~$21,597/year single; ~$44,367/year family of 4)
• Children: Generally covered at higher income levels
• Pregnant women: Higher income limits apply
• Seniors and people with disabilities: SSI recipients qualify automatically

Pennsylvania's Medicaid program is called Medical Assistance (MA). Coverage is provided through HealthChoices managed care plans. PA also offers CHIP for children above Medicaid limits and the Children's Health Insurance Program (CHIP) up to 314% FPL.

How to apply for Medical Assistance (MA)

You can apply through Pennsylvania's official portal, by phone, by mail, or in person at your local Pennsylvania Department of Human Services office.

• Online: Apply at COMPASS →
• Processing time: Most applications are processed within 45 days (90 days for disability-based applications)
• Coverage start: If approved, coverage typically begins the first day of the month you applied
• Renewal: Medicaid eligibility is reviewed annually — respond to renewal notices to avoid losing coverage

What does Medical Assistance (MA) cover?

Medicaid in Pennsylvania covers a comprehensive set of services, including:

• Doctor visits and preventive care
• Hospital stays (inpatient and outpatient)
• Emergency services
• Mental health and substance use treatment
• Prescription drugs
• Lab tests and X-rays
• Prenatal care and delivery
• Long-term care (nursing home and home-based services)

Most services are covered at no cost or very low cost. Some plans may charge small copays for non-emergency services.

What documents do I need?

• Proof of identity (driver's license, state ID, or passport)
• Proof of Pennsylvania residency (utility bill, lease, or bank statement)
• Proof of income (pay stubs, tax returns, or employer letter)
• Social Security numbers for all household members applying
• Proof of citizenship or immigration status

Common questions about Medical Assistance (MA)

Can I keep my doctor on Medical Assistance (MA)?

Medical Assistance (MA) is often provided through managed care plans. When you enroll, you will choose a plan and a primary care provider. If your current doctor accepts Medical Assistance (MA), you can stay with them. Call your doctor's office to confirm before enrolling in a plan.

What if my income changes?

Report income changes to Pennsylvania Department of Human Services within 10–30 days. If your income rises above the limit, you may qualify for marketplace coverage with subsidies instead — coverage is typically available without a gap.

Can I have both Medicaid and private insurance?

Yes. If you have employer coverage, Medical Assistance (MA) can act as secondary insurance, covering costs your primary insurance doesn't pay. This is called "dual coverage" and can significantly reduce your out-of-pocket costs.