Medicaid Rules in Pennsylvania

Pennsylvania state has implemented a medical assistance program for eligible low-income families. The state has set up a variety of rules and guidelines governing the program and its eligibility requirements. Those interested in or currently receiving help from the program are required to follow the rules in order to become eligible or maintain eligibility.

Personal Verification

• The Pennsylvania Medicaid program requires that applicants provide proof of identity in order to be eligible for the programs. The rules state that identity is verified by driver's license, state ID card, or another form of picture identification. Social security numbers must be provided for each person applying for assistance, and state residency verification is also required. Any resident applying for Medicaid must be a United States citizen to qualify.

Rules Regarding Income

• Eligibility for medical assistance is determined by assessing income and household size. Applicants are required to provide verification of all wages, interest and dividends, social security and veteran's benefits, and pensions. Each household member's income is considered when determining eligibility. Other sources of income include cash, bank accounts, stocks and bonds, life insurance policies, vehicles and owned properties.

Pregnant Women

• Pregnant women qualify for the regular Medicaid program, or can receive assistance from the Healthy Beginnings program. Income of the applicant's household must not exceed 185 percent of the federal poverty limit, or FPL.The rules for pregnant women state that the income limit applies to a pregnant woman, and her household size is increased by the number of unborn children. In other words, a woman who is having twins will count as three people when income limits are determined.

Refugee Medical Assistance

• Refugees applying for Pennsylvania Medicaid must prove immigration status and identification requirements. Income is not allowed to exceed 185 percent of the FPL, minus any medical expenses. The resource limit is $2,400 for a single person, $3,200 for two peoples and any additional person is $300. The rules regarding refugees states that the coverage is only for eight months, starting on the refugee's date of entry into the United States, or the date of granted asylum.

Families and Children

• The Pennsylvania Healthy Beginnings program covers infants under the age of one, with household income limits set at 185 percent of FPL; children ages one to six with an income limit being set at 133 percent of the FPL; and children ages six to 18, with income limits set at 100 percent of FPL. Children who are in Title IV-E foster care and state subsidized adoptions are automatically eligible for the program.