Having proper health coverage is an important part of any person’s personal and family life. You may qualify to receive federal and state funded insurance called Medicaid. Medicaid is an insurance program designed to support qualifying people who may need extra support, either financially or medically, with their insurance. In this guide, we will go through all the information you may need on applying for Pennsylvania Medicaid insurance.

What is Medicaid?

Medicaid is an insurance program run by the federal and state governments which provides low-cost or free health coverage for qualifying people who are disabled, pregnant, low-income individuals, families, or elderly.

Eligibility for the State of Pennsylvania

The distribution and eligibility requirements for Medicaid vary from state to state. According to the Pennsylvania Government Department of Health Services (DHS), there are different groups which are eligible for Medicaid. These are defined as:


●     Low-income (at or under the federal poverty line) adults between 19 to 64 years of age

●     Blind or disabled people aged 65 years or older

●     Families who have children younger than 21 years of age

●     People with conditions of Special Medical Assistance


To learn whether you qualify as low-income, you can check out the DHS website to find all of the information and qualifications needed. To determine your eligibility, you may have to provide evidence such as wages, Social Security, pensions, and veterans’ benefits.


You will also be required to provide proof of identity (such as a driver’s license or state identification card), a Social Security Number (SSN), proof of residency in the state of Pennsylvania, proof of United States citizenship (some exceptions may apply), and information on your household composition.

How to Apply

Once you have looked at the eligibility requirements and believe that you qualify for Medicaid, you can go ahead and begin the application process to receive Medicaid in the state of Pennsylvania. There are several ways you can apply for Medicaid. These include:


●     Online

●     By phone

●     In person


We will go through each option and its steps so you can decide which is the best application method for you.

When filling out the application, you will need to provide certain information on your personal situation including household income, federal tax information, SSN, current health insurance (if applicable), housing expenses proof, proof of citizenship or required documentation for qualifying non-US citizens, and resource information.


Applying online is the fattest and easiest way to submit an application. To apply online, you will need to go through the COMPASS website. This website allows for you to apply for Medicaid along with a number of other services to help if your financial situation is unstable.


If you are confused as to how to use their site, COMPASS has a page designed to provide you with navigation tips to make your application process as smooth as possible. COMPASS also has an app available for download on the iTunes and Google Play stores.


If you would rather apply over the phone, you can call the Consumer Service Center for Health Coverage at 1-866-550-4355 for more information.

In Person or by Mail

If you would rather apply in person or by mail, you will need to fill out the required documents on paper and send them in or drop them off at your local county assistance office. The specific office will depend on which county you live in. You can find out which Pennsylvania county assistance office is yours by following this link. If you are having issues with your application, someone from the office can help you.

Application Documents

If you decide to either submit your application in person or by mail, there are certain documents you will need to properly fill out for it to be considered complete. If you are choosing to fill it out by hand, here is a link to the application form for Pennsylvania residents. For a version in Spanish, click here.


Additional Healthcare Programs for Pennsylvania Residents

There are many healthcare programs available through the state of Pennsylvania for its residents in the case of life-threatening or non-life-threatening medical conditions. You can find a list of all of their available health programs here. These include:


●     Breast and Cervical Cancer Screening and Treatment

●     Dental Service

●     HealthChoices

●     Health Insurance Premium Payment (HIPP) Program

●     Home and Community-Based Services

●     Limited English and Interpreters

●     Medical Assistance Transportation Program (MATP)

●     Medical Assistance Benefits for Workers with Disabilities

●     Medical Assistance for Children and Pregnant Women

●     Mental Health and Substance Abuse

●     Prescription Drug Coverage

●     Reproductive Health


These programs may be available for individuals who are not eligible to receive Medicaid benefits. You can contact your local county assistance office for more information about the eligibility requirements for the different programs available through the state of Pennsylvania.


Where Can I Find Information about Providers Accepting MA Patients?

You may be unsure whether you and your household qualify to receive Medicaid benefits. If this is the case, you can get in touch with a professional to help answer any and all questions you may have. To find information regarding eligibility and Pennsylvania Medicaid, you can either:


●     Call: 1-800-537-8862


You can also visit the Pennsylvania Provider Search Tool to help locate providers to contact specifically.


Having access to medical coverage is crucial to ensure the physical and mental safety of both you and your household. If you fit with one or more of the eligibility requirements for Medicaid and live in the state of Pennsylvania, make sure to begin your application process so you can get your coverage as quickly as possible. Whether online, over the phone, in person, or by mail, there are many options for applying to receive the benefits you need.