How Is Medicaid Eligibility Determined in Pennsylvania?


Quick Answer

Since the state of Pennsylvania has accepted federal Medicaid expansion, all low-income adults within 138 percent of the federal poverty level, or FPL, may qualify for Medicaid coverage. Non-financial criteria for determining Medicaid eligibility include residency, immigration status and documentation of United States citizenship, according to the Medicaid website.

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Full Answer

In 2010, the Affordable Care Act of 2010 was signed by President Barack Obama, which set the minimum Medicaid eligibility level at 133 percent of the federal poverty level. Medicaid covers nearly all Americans under the age of 65. The expanded Medicaid became effective on January 1, 2014.

The FPL is basically a yardstick of income levels. It is adjusted yearly and is issued by the Department of Health and Human Services. The FPL determines an individual's eligibility for certain programs and benefits, such as Medicaid, according to the HealthCare.gov website.

Pennsylvania has accepted federal Medicaid expansion and it came into effect on January 2015. Adults with incomes up to 138 percent of the FPL, as well as children in households with income of up to 319 percent of the FPL, as of 2015, are eligible for Medicaid coverage. Enrollment for the expanded Medicaid program in the state began in December 1, 2014. Pennsylvania residents can apply for Medicaid coverage online, by phone or at local County Assistance offices.

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