What Are Some Facts About the Pennsylvania Medical Assistance Program?

What Are Some Facts About the Pennsylvania Medical Assistance Program?

The Pennsylvania Medical Assistance Program is Medicaid. Medicaid is a government program that provides health insurance to people with low incomes. Pennsylvania's Medical Assistance Program provides physical and behavioral health care coverage.

The federal government established Medicaid in 1965. In 2010, the Patient Protection and Affordable Care Act permitted states to expand Medicaid eligibility to individuals with income of up to 133 percent above the poverty line. Pennsylvania chose to expand Medicaid eligibility.

In Pennsylvania, individuals can find out if they are eligible for the Medical Assistance Program by submitting an application. Individuals have the option of applying by phone, online or at their county assistance office. The state usually responds to applications within 30 days, although if a patient has an "urgent medical need," the state responds in five days. To establish proof of an "urgent medical need," the applicant needs to submit a note from a medical practitioner. The note must include the diagnosis and state that the individual has an "urgent medical need."

Individuals who are approved for Medicaid receive a benefits card, also known as an ACCESS card. Individuals who live in parts of the state where Medicaid managed care is available also receive an insurance card from an HMO. Individuals have a choice of HMO.

Individuals who do meet the eligibility requirements for Medicaid can contact their county assistance office for information about other programs that might provide help.