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Medical Assistance (Medicaid) Financial Eligibility Application for Long Term Care, Supports and Services. Check any that you are applying for: Home and Community Waiver Services – Type/Name of Waiv. Please read the entire form. Print the requested information in the unshaded sections.
Download, fill out, and print a paper application then send it to your local County Assistance Office. Download a form (PDF)
The following forms are needed to apply for medical assistance: PA 600 - Application for Benefits, including the Provider Addendum. MA 314 - Eligibility Determination Form (for inpatient care only)
If you don’t have a social security number, reach out to your local County Assistance Office to apply for one. Medicaid is available to Pennsylvania residents, regardless of how long you’ve been a Pennsylvania resident. Medicaid is available to United States citizens, refugees, and lawfully admitted non-citizens.
You can apply online at www.compass.state.pa.us. in Pennsylvania. Easy, affordable protection for your family. Information about Health Care Coverage. Please note: If you need Medicaid benefits for families without children, cash assistance, or food stamps, you must complete a different application.
Learn who’s eligible to enroll in Pennsylvania's Medicaid program, how to apply, the status of Medicaid expansion and the effects of Medicaid disenrollment. Please provide your zip code to see plans in your area.
How to apply for Medicaid in Pennsylvania: Online: www.compass.state.pa.us. By Phone: 1-866-550-4355. In-Person: See listing of local County Assistance Offices (CAOs) By Mail: Send the completed application form, PA 600 HC, and all supporting documents, to your local CAO. Download the application form in other languages below:
