Pennsylvania Federal Poverty Income Guidelines for Medicaid

Medicaid is a federally funded program that covers medical care for people with low income or certain medical conditions. In Pennsylvania, Medicaid is referred to as Medical Assistance. It is available to qualifying state residents who are citizens or permanent residents of the United States. To be eligible, residents generally have to have a low income, and be pregnant, have a child with a disability or be a caretaker for children younger than 19 years old. However, eligibility guidelines aren't this simple. To see if you are eligible for Medicaid, you should contact the County Assistance Office in the Pennsylvania county where you live. You can also apply for Medicaid online.

Income limits for adults

• In Pennsylvania, Medicaid is available to different categories of adults between the ages of 21 and 64. Each category has its own income limit.

  For example, adults are considered "categorically needy" if they are being treated for addictions to drugs or alcohol, have a documented disability or are victims of domestic violence. This category also applies to two-parent groups who do not meet other eligibility requirements.

  To be eligible for Medical Assistance, a one-person "categorically needy" household cannot have more than $215 in monthly income. There are higher limits for households with more people.

  Adults are considered "medically needy only" if they have dependent children younger than 21, are eligible refugees, or are between the ages of 21 and 58 and work at least 100 hours per month. People between the ages of 59 and 64 also fall into this category.

  To be eligible for Medicaid, "medically needy only" people cannot have more than $425 in monthly income or more than $2,550 of income over six months. Households with more people have higher eligibility limits.

Income Limits for Families, Children, Pregnant Women

• Pennsylvania considers families and children "categorically needy" if they:

  -- Receive Temporary Assistance for Needy Families, commonly known as welfare
  -- Receive Supplemental Security Income

  Families in this category are eligible for Medicaid if their income is under certain limits. In Pennsylvania, this limit is $330 per month for two people. There are higher limits for bigger families.

  Pregnant women and children are eligible for Medical Assistance through Pennsylvania's Healthy Beginnings program. To be eligible for this program, families must have income under certain limits. For two-person families this limit is $2,247 per month for pregnant women with infants, $1,615 per month for children between the ages of 1 and 5, and $1,215 for children age six and older.

  Healthy Beginnings counts a woman as two people if she is pregnant with one child and three people if she is pregnant with twins.

Income Limits for People with Disabilities and Adults Older Than 65

• Pennsylvania considers adults "categorically needy" if they receive Supplemental Security Income or are disabled, blind or older than 65. To be eligible for Medicaid, one "categorically needy" person cannot have an income of more than $701.40 per month and two can't have more than $1,054.70 in monthly income.

  To be eligible for Medical Assistance, one person in this category cannot have an income of more than $425 per month or $2,550 over six months. There are higher limits for households of more people.

Determining Income

• When Pennsylvania is deciding whether someone is eligible for Medicaid, several kinds of income are counted. They include: wages, income from live-in spouse, Social Security income, Veterans' benefits, pension income, interest and dividends

  Other kinds of income don't count for Medicaid eligibility, such as: food stamps,
  foster care payments, some housing and utility subsidies, temporary Assistance for Needy Families, Supplemental Security Income

Determining Resources

• To decide whether people is eligible for Medicaid, Pennsylvania also looks at the resources available to them. These include:

  Cash, bank accounts, stocks and bonds, vehicles, life insurance, trust funds, property one does not live on

  Other resources are not counted toward eligibility for Medical Assistance: residence, one vehicle, cemetery plots and grave markers