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Medical Assistance Benefits in Pennsylvania

Medical Assistance is the name of Pennsylvania's Medicaid program. Medical Assistance benefits provide financially needy residents with health insurance and other health services. Pennsylvania extends benefits to adults and children of all ages, depending on need. Although funding is through both the federal and commonwealth governments, the commonwealth is entirely responsible for the administration of the Medical Assistance benefits program.

  1. Medical Assistance

    • Medical Assistance programs are comprehensive managed health insurance plans. Services include routine care, emergency care, preventive care, prescription benefits, mental health, substance abuse and dental care among others. To provide greater access to benefits and services, Medical Assistance programs in Pennsylvania offer translators for non-English-speaking participants, representatives to help schedule doctors appointments and transportation assistance to and from doctor's appointments. These plans require selection of a primary care provider who coordinates most of your health care needs.

    HealthChoices and Access Plus

    • HealthChoices is the name of the Medical Assistance health insurance program in Bucks, Chester, Delaware, Montgomery, Philadelphia, Allegheny, Armstrong, Beaver, Butler, Fayette, Green, Indiana, Lawrence, Washington, Westmoreland ,Adams, Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton, Perry and York counties. Access Plus is the Medical Assistance program for 42 Pennsylvania counties in northern and central Pennsylvania. Access Plus providers full health insurance in Bedford, Blair, Bradford, Cambria, Cameron, Carbon, Centre, Clarion, Clearfield, Clinton, Columbia, Crawford, Elk, Erie, Forest, Franklin, Fulton, Huntingdon, Jefferson, Juniata, Lackawanna, Luzerne, Lycoming, McKean, Mercer, Mifflin, Monroe, Montour, Northumberland, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Wayne and Wyoming counties.

    SpecialCare

    • SpecialCare is a health insurance plan offered by regional Blue Cross Blue Shield companies. You must meet certain low-income requirements to qualify for this plan. SpecialCare offers subsidized premiums to help pay for health insurance. This program is similar to a program once offered by Pennsylvania called adultBasic. Though adultBasic is no longer available, participants who qualified for that program will qualify for SpecialCare, although rates are typically higher and coverage is more limited. To apply for SpecialCare, you must contact your regional Blue Cross and Blue Shield company.

    How to Apply

    • To apply for Medical Assistance benefits in Pennsylvania, visit the COMPASS website (see Resources). COMPASS is the online application for various Pennsylvania benefits. Once on the COMPASS site, you can click "Apply Now" or "Apply for Benefits" to access the questionnaire needed to apply. You will need to set up an account to use the system. After submitting the application, you can check the status of your application online. If you do not have access to a computer or need further assistance with applying, you can contact the Pennsylvania Department of Public Welfare at 800-692-7462 or apply at your county assistance office (see Resources).

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