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    Medical Assistance General Eligibility Requirements

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    General Eligibility Requirements

    You must meet income, resource (in many cases), and other eligibility requirements in order to be eligible for Medical Assistance. These categories are grouped by:

    • Individuals who are aged (age 65 and older), blind and disabled. (Identified for Medical Assistance purposes as SSI-related)
    • Families with children under age 21. (Identified for Medical Assistance purposes as TANF-related)
    • Single and married individuals with a temporary disability, age 59 through 64, limited income or special circumstances (Identified for Medical Assistance purposes as GA-related):
      • Under-going drug and alcohol treatment
      • Victim of domestic violence
      • Caring for a child or disabled person
    • Special Medical Assistance conditions.

    Income

    Medical Assistance eligibility is determined using income and household size in comparison to income limits. Age and disability are also factors in determining which income limits apply. (Income limits for the various eligibility groups are listed below.)

    Examples of income counted in determining eligibility include:

    • Wages (certain deductions are allowed)
    • Interest
    • Dividends
    • Social Security
    • Veterans' Benefits
    • Pensions
    • Spouse's income if living with him/her

    Examples of income not counted when determining eligibility include:

    • Temporary Assistance for Needy Families (TANF) benefits 
    • Supplemental Security Income (SSI) 
    • Supplemental Nutrition Assistance Program (SNAP) benefits
    • Low Income Home Energy Assistance Program (LIHEAP) benefits
    • Foster Care payments
    • Certain housing or utility subsidies
    • Weatherization Payments

    Income Limits

    The income limits for each category are provided in the section for that category.

    Resources

    Medical Assistance eligibility is also determined using resource and household size in comparison to resource limits. (Resource limits for the various eligibility groups are listed below or in the section for that category.)

    NOTE: Resource limits do not apply for families with children in the household, under their care and control, and under the age of 21.

    Examples of resources counted in determining eligibility include:

    • Cash
    • Checking accounts
    • Savings accounts and certificates
    • Christmas or vacation clubs
    • Stocks and bonds
    • Some trust funds
    • Life insurance
    • Vehicles
    • Revocable burial funds
    • Non-resident property

    Examples of resources not counted in determining eligibility include:

    • Your home
    • Revocable and irrevocable burial reserves subject to specified limits
    • Burial space and marker
    • One motor vehicle

    Resource Limits

    Each Medical Assistance eligibility group has resource limits. The charts below provides specific details:

    Non-Money Payment (NMP) Medical Assistance

    GA-RelatedSSI-Related
    One Person = $250One Person = $2,000
    Two People = $1,000Two People = $3,000

    TANF-related = Does not apply: Resources for families with children in the household and under care and control are excluded.

    Medically-Needy Only Medical Assistance

    GA or SSI-RelatedCost Sharing, Specified Low-Income Medical Assistance Beneficiary, Qualifying Individual Categories
    One Person = $2,400One Person = $7,160
    Two People = $3,200Two People = $10,750
    Each Additional Person = $300 

    TANF-related = Does not apply: Resources for families with children in the household and under care and control are excluded.

    Other Eligibility Requirements

    • Identity -- Identity can be verified by a driver’s license, state identification card or another piece of identification.
    • Social Security Number (SSN) -- A SSN must be provided for each person applying for Medical Assistance. County Assistance Office staff will help you apply for an SSN for anyone who does not have one.
    • Residency -- Medical Assistance is available to individuals who are residents of Pennsylvania if all other eligibility requirements are met. There is no requirement regarding the length of time that a person must live in Pennsylvania.
    • Citizenship -- Medical Assistance is available to United States citizens, refugees and certain lawfully admitted aliens. Other aliens may be eligible for limited Medical Assistance benefits if an emergency medical condition exists. U.S. citizens, refugees and legal aliens must submit documentation proving U.S. citizenship or legal alien status.
    • Household Composition -- County Assistance Office staff will determine who are mandatory or optional budget group members in the Medical Assistance application based upon household relationships and individual needs for Medical Assistance.