Who is Eligible to Obtain Medicaid in Pennsylvania?

medicaid-logoMedicaid was formed in 1965 as part of the U.S. Social Security Act. The program, which is both financed by federally and state governments, has grown over the years from a basic welfare system into a larger-scale public health insurance service. Pennsylvania’s Medicaid program is called Medical Assistance, and is managed by the state’s Department of Public Welfare (DPW).

Medicaid is a health coverage program for the disabled, elderly, pregnant women and children who meet specific guidelines.

General Requirements

Read The Fine PrintYou must be able to present proof of identity by providing your local Medicaid office with a state-or federally issued Social Security card, photo identification card and proof of residency and citizenship for all household members. This must be submitted with your initial Medicaid application.

Groups Covered

Medicaid assistance is valid only to a select set of coverage groups. These groups comprise low-income families with children, low income adults, pregnant women whose income is below 133 percent of the federal poverty line, recipients of adoption or foster care assistance, Supplemental Security Income recipients age 65 and over and certain Medicare beneficiaries. Pennsylvania also pulls out Medicaid coverage on a case by case basis to elective groups of medically-need residents, such as children with disabilities, individuals who are in institutions, low-income women with breast or cervical cancer, and adults with disabilities

Income Requirements

Income Requirements for Medicaid EligibilityOne of the key eligibility categories is income. You must meet certain household income requirements so as to qualify for Pennsylvania Medicaid. The maximum income limit differs depending on the specific Medicaid program. Sources of income that are counted take in interest, wages, dividends, veteran’s benefits, Social Security disability & retirement benefits, and income through self employment.

Income sources that are not included comprise Temporary Assistance for Needy Families (TANF), energy assistance, foster care payments, food stamps, Supplemental Security Income (SSI), weatherization payments and housing subsidies.

Asset Requirements

You must meet resource limits to be eligible for Pennsylvania Medicaid. The specific resource limit varies depending on your household size and type of Medicaid coverage. It is also factor into an applicant’s eligibility. Applicants must show the full extent of their assets and resources, including stocks and bonds, cash, savings accounts, checking accounts, other bank accounts with a cash value, some trust funds, life insurance, vehicles, revocable burial trusts and nonresident property. Your home, burial space and marker, final burial trusts, and one motor vehicle if used for conveying the recipient of Medicaid coverage are not included.


Qualified recipients will also have to offer proof of residency in the state of Pennsylvania. Moreover, applicants must show proof of U.S citizenship of permissible immigration status. Foreign residents living legally in Pennsylvania may still be entitled for Medicaid, but illegal immigrants cannot be eligible for benefits.


If you are applying for Pennsylvania Medicaid on the basis of disability, you must be able prove disability by presenting medical records, statements from individuals familiar with your disability, employment records and other documents that explain that you are unable to maintain gainful employment. In case you sign an information release, your local Medicaid office and the medical review team can get these records on your behalf.

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