Requirements for Medicaid in Pennsylvania

Medicaid provides health care for eligible, low income families or individuals with higher medical expenses. About 64 percent of Pennsylvanians below the age of 65 have private health insurance as a work benefit. The majority of recipients are below the age of 18 who account for 46 percent, according to state records; only 10 percent are 65 years or older.

Eligibility

• You must be a United States citizen or a legal permanent resident, though other qualified immigrant statuses are eligible for full medical assistance. You must also be a resident of the state and have a financial situation characterized as low income. If very low income, you must also be pregnant and be responsible for minors younger than 19. Medicaid finances about 65 percent of all Pennsylvania in nursing homes and pays for prescription drugs.

Emergency Medical Assistance

• Immigrants who do not qualify for full medical assistance are allowed to receive emergency medical assistance (this includes immigrants on student visas or undocumented immigrants. EMA allows for the temporary enrollment in Meicaid to treat a specific problem. Enrollment is terminated after the treatment. An immigrant must have a medical condition with symptoms that require immediate attention. This includes labor and delivery services. However, it does not provide for procedures such as organ transplants.

Payment

• Payment is made directly to health care providers. A person may also qualify for medical services that were provided up to three months before a Medicaid application was completed. You can request medical assistance for yourself or other family members who wish to be included. The application is for medical services covered by Medicaid programs. An application for a deceased person will be accepted if the person died during the month of application or during the three calendar months before the month of application. A relative or the agency which provided the service could sign the application.