Medical Assistance: Income Limits, Eligibility and How to Apply
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Medical Assistance is Pennsylvania's Medicaid program, and it is run by the Pennsylvania Department of Human Services. Pennsylvania adopted the Affordable Care Act expansion in 2015, so an adult under 65 qualifies on income alone at or below 138% of the poverty guideline: $1,835 a month for one person in 2026. Children are covered through Pennsylvania CHIP, and the application is at www.compass.dhs.pa.gov or 866-550-4355. Every figure below is dated 2026-09-23.
| Program | Medical Assistance (HealthChoices) |
|---|---|
| Children | Pennsylvania CHIP |
| Agency | Pennsylvania Department of Human Services |
| Apply | www.compass.dhs.pa.gov · 866-550-4355 |
| Expansion | Yes, since 2015 |
| Adult income limit, 2026 | $22,025 a year for one person; $45,540 for four |
| Work requirement | federal deadline January 1, 2027 |
| Plans | Physical, behavioral and long-term care each run through their own HealthChoices managed care plans. |
Who qualifies in Pennsylvania
Adults 19 to 64 not on Medicare qualify at or below 138% of poverty (133% plus a 5% disregard), on household modified adjusted gross income, with no asset test. The 2026 figures:
| Household size | Annual income at 138% | Monthly | 100% of poverty (marketplace floor) |
|---|---|---|---|
| 1 | $22,025 | $1,835 | $15,960 |
| 2 | $29,863 | $2,489 | $21,640 |
| 3 | $37,702 | $3,142 | $27,320 |
| 4 | $45,540 | $3,795 | $33,000 |
| 5 | $53,378 | $4,448 | $38,680 |
Computed from the 2026 HHS poverty guidelines (January 15, 2026).
Children (Pennsylvania CHIP), pregnant women, parents, seniors and people with disabilities use other limits that Pennsylvania sets above the federal minimums.
How Pennsylvania compares
Pennsylvania expanded in 2015, later than most; only 11 states have done so since. On the work requirement it is not among the early starters (Arkansas, Iowa, Montana, Nebraska), so members have until January 1, 2027. The program's own name, Medical Assistance, is what appears on cards and letters; "Medicaid" may not appear at all, which confuses people who move here.
How to apply for Medical Assistance
- Apply online at www.compass.dhs.pa.gov, or call 866-550-4355. HealthCare.gov also takes Medicaid applications and forwards them to Pennsylvania. There is no enrollment period; any day works.
- Report this month's income. Choose a plan when asked, or one is assigned.
A Medical Assistance case also qualifies you for a free phone (Pennsylvania carriers, paperwork) and shares documents with Pennsylvania SNAP.
What changes in Pennsylvania
Pennsylvania has not announced a start date for the federal work requirement, so it takes effect on the federal deadline, January 1, 2027. Six-month renewals for expansion adults begin with renewals scheduled on or after January 1, 2027. The nationwide changes are on the hub with CMS sources.
Pennsylvania specifics
- Pennsylvania keeps CHIP as a separate program with its own plans, so a child who ages out of Medicaid income is moved rather than dropped.
- Offices serve Philadelphia, Pittsburgh, Allentown and every county; hospitals and health centers also employ enrollment assisters.
Whether Medical Assistance pays for dental or weight-loss drugs is Pennsylvania's choice; see does Medicaid cover.
Common questions
What is the Medicaid income limit in Pennsylvania for 2026?
$22,025 a year for one adult, $29,863 for two and $45,540 for four (138% of the 2026 poverty guideline); children go higher through Pennsylvania CHIP.
Does Pennsylvania have a Medicaid work requirement?
From January 1, 2027, the federal deadline; Pennsylvania has not set an earlier date. It applies to expansion adults 19 to 64 at 80 hours a month, with exemptions listed on the hub.
Sources
- Medical Assistance: state program page
- HHS: 2026 poverty guidelines
- HealthCare.gov: Medicaid expansion and you (138%)
- Federal Register: community engagement interim final rule (June 3, 2026)
- CMS: 2025 law section-by-section overview
Gov-Grants.org is an independent guide, not a carrier and not a government agency. We never charge fees, and every fact above links to its source with the date we checked it. Program details change; confirm on the official site before applying.