Medicaid Eligibility in PennsylvaniaUpdated December 12, 2017 Medicaid
The federal government funds many Medicaid programs, but only those residents who qualify in each state get access to the funds available. Low-income households may apply if they require medical assistance in Pennsylvania. People who have a difficult time affording regular hospital and physician rates may be able to get state covered insurance that will pay a significant portion of the costs.
Pennsylvania has its own rules regarding requirements for citizens to meet and eligibility for residents of the state. Look into all stipulations set forth before applying.
Pennsylvania’s Requirements for Medicaid Qualification
The Medicaid program of Pennsylvania follows certain requirements that enrollees must meet. Using the COMPASS questionnaire, those who wish to apply for benefits can see if they or anyone in their household may get approved. The name, age, and gender of each household member must get added. It is also important to note the approximate total value of resources available to the family.
Once all questions get answered and the form gets submitted through the system, an answer will be given informing the applicant of his or her potential to receive benefits. People who fall below the poverty limit are often among the first to receive assistance.
How to Apply for Medicaid in Pennsylvania
Several methods exist for applying for coverage in Pennsylvania. Many people use the online option as a quick way to fill out the application and get approval or denial notifications fast. The COMPASS website offers an easy-to-use application form. Applicants may also call 1-866-550-4355 to apply by telephone, visit their local county office, or download the forms and send them to their local office.
Pennsylvania Medicaid Application
Applying for Medicaid can be done solely, without the need to request any additional assistance. The process starts by describing the names and ages of each member of the household, as well as answering some questions about pregnancy, disabilities, nursing home needs, and whether anyone has bills from the last three months they need help paying. You must also disclose the annual household income received. The website indicates it may take between 20 and 45 minutes to complete the full application. A username and password must then get created to set up an account and begin the actual process.
What Does Medicaid Cover in Pennsylvania?
The Medicaid program through the state of Pennsylvania covers an extensive list of medical services. Yearly visits, often known as well-checks, should get utilized by every person receiving medical assistance. Free or low-cost emergency room visits, trips to urgent care, emergency dental services, and more also get offered, which people should use when truly necessary.
Senior citizens may also receive in-home care or a short stay at a nursing facility if needed. Medicaid often covers these costs for a specific timeframe, which will get detailed in the insurance plan.
Income Requirements for Pennsylvania Medicaid
Household size, the total of outgoing bills, and eligibility requirements help determine the income requirements for each family applying for Medicaid in Pennsylvania. The amount varies for everyone based on these details. Single adults between the ages of 19 and 64 must have an income that falls below 133% of the federal poverty guidelines to be eligible. A maximum income of $15,800 per year, or roughly $1,317 per month, is designated to an individual.
How Much Does Medicaid Cost in Pennsylvania?
The federal government, partnered with the state of Pennsylvania, spends a total of more than $27 billion per year on Medicaid costs. Thirty-seven percent of the state’s budget is allocated to these funds. Plans to expand the program are in the works, meaning even more people will get access to some of the funds for medical coverage.
Cost and Coverage of Medicaid in Pennsylvania
Low-income families may not be able to afford regular health care coverage. Medicaid combats that problem, giving those who cannot pay an opportunity to receive medical care and be seen by a regular physician. The state takes on the expenses so the people do not have to pay anything. Adults who are capable of working and paying at least a portion of the costs may have a set copay amount for emergency room visits, clinic appointments, and also for prescriptions, usually around $3 each. People who receive general assistance may have a higher payment, up to $6.
Prescription Drugs with Medicaid in Pennsylvania?
Medicaid in Pennsylvania does not cover all prescription drugs. It does, however, cover some of them, allowing people to pick up the prescriptions they need for free. Adults may have a small copay of $3 to pick up their prescriptions. This price is for brand-name medicines. Generic versions often cost just a dollar.
Which Medicaid plan is best in Pennsylvania?
Health Partners Plans’ Medicaid Plan was rated one of the top choices in Pennsylvania. More than 180,000 Medicaid members use this plan. It is especially satisfactory as child’s health coverage.