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Medicaid eligibility is based on factors such as a person’s income, family size, age, and disability status. Eligibility for Medicaid can vary based on a person’s specific circumstance, and the best way to find out if you or your loved one are eligible is to complete an application.
Medical Assistance eligibility is grouped by: Modified Adjusted Gross Income (MAGI) Children aged 18 and under. Pregnant women. Parents and caretakers of children under 21. Adults ages 19-64 with incomes at or below 133 percent of the Federal Income Poverty Guidelines (FPIG) Family planning services. Non-MAGI.
Pennsylvania's Medical Assistance (Medicaid) program provides health care benefits for older people (ages 65 and older), people with disabilities, or people who are blind. Information on this page describes general eligibility requirements and benefits.
A Home and Community-Based Service (HCBS) Program for eligible adults age 21 and over. An Individual Service Plan (ISP) containing specific, personalized information is provided for each Waiver consumer.
Since January 1, 2015, all legally present adults under age 65 in the Commonwealth of Pennsylvania – parents or not – are eligible for Medicaid with household incomes up to 138% of poverty, as long as they meet Medicaid’s immigration requirements.
Pennsylvania's Medicaid program, also known as "Medical Assistance", provides comprehensive health care coverage for vulnerable populations and people with limited incomes. Historically, Medicaid was only available to narrow groups, such as low-income children and adults with disabilities.
Medicaid: Provides health care coverage for children under age 21, pregnant women, and other adults. CHIP: Provides health care coverage for children under age 19 who do not have health insurance and who are not eligible for Medicaid.
