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Grateful acknowledgement to Rebecca Wright, Stacey Coggins, and S. Mita
Chatterjee for their work on previous editions of this manual.
Copyright © February 2016

Medical Assistance
Eligibility Manual






About PHLP
The Pennsylvania Health Law Project is ac nonprofit organization.
PHLP is a nationally recognized expert on access to health care for low- income consumers, the elderly, and persons with disabilities. PHLP engages indirect advocacy on behalf of individual consumers while working on the kinds of health policy changes that promise the most to Pennsylvanians in need. Pennsylvania Health Law Project Helpline 1-800-274-3258 www.phlp.org

This publication is intended to provide general legal information, not legal advice. Each person’s situation is different. If you have questions about how the law applies to your particular situation, please consult a lawyer or call the Helpline at 1-800-274-3258.




Table of contents
Medical assistance for older adults & adults with disabilities
Medical assistance how to apply
How do i qualify
For immigrants what is your immigration status
Are you under the income and resource limits for that category
Can i qualify for ma if i have another health insurance
Medical assistance categories
Birth to age 1
Children with disabilities
Interest or dividends
Household size
Presumptive eligibility
Former foster youth
If you are on medicare and qualify for healthy horizons:
Qmb: qualified medicare
Medicare savings programs
The work requirement is flexible
Mawd has a monthly premium
Resources for individuals overage, there is a resource limit of $8,000.
What services does a waiver program provide?
How do i apply fora waiver
How do i apply for the breast and cervical cancer treatment program
Breast and cervical cancer prevention and
Income and resource
Modified adjusted gross income (magi)
What income counts
Who is in the magi household
The rules for tax filers
The rules for tax dependents
Counted in hh



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