Pennsylvania Medicaid Program & Eligibility
Coverage, eligibility, and how to get Medicaid help in Pennsylvania.
Medicaid Expansion
State Coverage
Medicaid in Pennsylvania
PA Medicaid Eligibility
- You live in Pennsylvania
- You are a U.S. citizen, national, or a qualified immigrant
- Your household income is at or below the limit for the specific program that applies to you
Pennsylvania's program covers several groups of people:
- Children under age 19
- Pregnant women
- Parents and caretakers of dependent children under 21
- Adults ages 19-64
- Seniors (65+) and people who are blind or have a disability
Applying for Medicaid
Pennsylvania has multiple ways to apply for Medical Assistance, so you can choose the option that works for you.
- Online: Apply through COMPASS at compass.state.pa.us
- By phone: Call the Consumer Service Center for Health Care Coverage at 1-866-550-4355
- By mail: Download and complete an application and mail it to your local County Assistance Office (CAO)
- You can download a paper application here
- Find your local County Assistance Office using the DHS office locator
- In person: Bring your paper application to your local County Assistance Office.
- You can download a paper application here
- Find your local County Assistance Office using the DHS office locator
For your application, you should have the following information handy for yourself and anyone in your household (even if they don't need coverage):
- Dates of Birth
- Social Security Numbers
- Visa, green card, or immigration documents (if applicable)
- Most recent W-2 and/or Form 1040, 1099
- Pay stubs, Profit & Loss Statements, or other employment information
- Current insurance coverage, if any (policy numbers for any health insurance plans currently covering members of your household)
After Applying
After you apply, the state of Pennsylvania will review your application and notify you of your eligibility.
While your application is under review: You may receive a notice in the mail from the state requesting proof of income and proof of identity or citizenship. Make sure to respond promptly so that your application can be processed without delays.
Track your application: After you apply, you can go to trackmybenefits.pa.gov to see updates on your application.
If you're approved:
- Coverage may start right away or be retroactive, meaning Medical Assistance may help cover bills you've already received.
- You'll receive a member ID card in the mail. Keep it safe and bring it to all medical appointments.
- You will be able to pick a Medicaid managed care plan to access care.
Staying enrolled:
- Report any changes in income, household size, address, or family status as soon as possible, through COMPASS or by calling your County Assistance Office.
- Your coverage must be renewed annually. Watch for renewal notices in the mail and respond promptly to avoid losing coverage.
Income Limits
Income limits for Medical Assistance depend on your household size and what program applies to you.
What’s Covered
Doctor and Hospital Visits
Preventative Care and Screenings
Mental Health and Substance Use Treatment
Prescription Drugs
Maternity and Newborn Care
Dental and Vision Services
Medical Equipment
Emergency Transportation Services
Need help with Medicaid in Minnesota?
Below are some of the most commonly asked questions.
Medicaid in Minnesota is a public health insurance program that provides free or low-cost health coverage to eligible low-income individuals and families. In Minnesota, Medicaid is called Medical Assistance.
If your income is too high for Medicaid (Medical Assistance), you may still qualify for free state health coverage through MinnesotaCare. If your income exceeds MinnesotaCare's limits, you may still be able to enroll in an affordable paid plain through MNSURE.
How you apply depends on your age and situation:
- Adults under 65 typically apply through MNSURE
- Seniors (65+) and people with disabilities usually apply through their local Department of Social Services (DSS)
Applications can be submitted online, by phone, by mail, or in person.
Filling out government forms (paper or digital) can be confusing. We know the anxiety of missing important mail from the state. We built Fortuna to take the stress out of health plan coverage.
We provide your own dedicated navigator available by phone and chat to help you out!
For most people, Medicaid in Minnesota (Medical Assistance) has no monthly premium and very low or no out‑of‑pocket costs. Some services may require small copayments, but many groups (such as children and pregnant individuals) are exempt.
Medicare is health insurance that generally covers people aged 65+. Medicaid covers people of all ages if you make below a certain income or face hardship based on other circumstances like disability.
Fortuna focuses on Medicaid. If you need Medicare support, we can help you enroll onto a Medicare-Medicaid program.
Yes, if Fortuna is available through our partner health plan and providers. Please contact your insurer or provider for more information.
Yes, Fortuna is only available through providers and insurers. Please contact us at info@fortunahealth.com for more information.
Ready to renew or start your coverage?
Take the next step and keep your Medicaid benefits active with Fortuna’s simple, guided process.
