This section of PALawHelp.org has information and resources about Medical Assistance issues in Pennsylvania.
Click on a resource category listed below to see information related to that category.
Benefits Check Up for Seniors
BenefitsCheckUp connects older adults and people with disabilities to programs that can help them afford daily expenses, live healthy, and stay independent. This free tool makes it easy to find programs that can boost your budget—then shows you how to learn more and apply online. See what's available in your area by entering your ZIP code on the site.
Benefits.gov
Benefits.gov is the official benefits website of the U.S. government whose mission is to increase citizen access to benefit information, while reducing the expense and difficulty of interacting with the government. It is a free, online confidential tool that helps you find government benefits you may be eligible to receive. Use the benefit finder tool or search by category to learn which benefits you and your family may be eligible for and learn how to apply for what you qualify for.
COMPASS
COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information, including SNAP, TANF, Medicaid, LIHEAP and other social service programs.
Fact Sheet: Medical Assistance Transportation Program (MATP)
The Medical Assistance Transportation Program (“MATP”) is available to any Medical Assistance (“MA”) enrolled consumer who needs help with non-emergency transportation to and from MA-covered health care services or treatments. This information from the Pennsylvania Health Law Project explains the transportation services available through the PA Medical Assistance program. [PDF] (April 2013)
Medicaid Health Insurance Premium Payment Program (HIPP)
Medicaid Health Insurance Premium Payment Program (HIPP) was developed to help families with at least one person enrolled in Medicaid pay for private health insurance through an employer.
Medicaid/Medical Assistance
This is the section of the Pennsylvania Department of Human Services website with information for people applying for or currently receiving Medicaid, also known as Medical Assistance (MA).
Medical Assistance for Workers with Disabilities (MAWD) - A Guide to Eligibility
Medical Assistance for Workers with Disabilities (MAWD) is a state health insurance program for people who are working and have a disability or serious health condition. MAWD is often a good option for people who make too much money to qualify for other categories of Medical Assistance (MA or Medicaid) but who nonetheless need health insurance. MAWD provides comprehensive health insurance coverage and as compared to other MA programs, has high income and resource limits. MAWD also has flexible work and disability requirements. This guide explains each MAWD eligibility requirement in depth and tells you how to apply for MAWD coverage. (January 2025)
Pennsylvania Breast & Cervical Cancer Early Detection Program
Information on the Pennsylvania Breast & Cervical Cancer Early Detection Program, which is a free breast and cervical cancer early detection program of the Pennsylvania Department of Health. It is funded by the Department of Health and through a grant the Department receives from the Centers for Disease Control and Prevention.
Fact Sheet: Medical Assistance Transportation Program (MATP)
The Medical Assistance Transportation Program (“MATP”) is available to any Medical Assistance (“MA”) enrolled consumer who needs help with non-emergency transportation to and from MA-covered health care services or treatments. This information from the Pennsylvania Health Law Project explains the transportation services available through the PA Medical Assistance program. [PDF] (April 2013)
How to Appeal a Denial in Community HealthChoices
If your Community HealthChoices (CHC) managed care plan denies your request for a service, such as personal assistance services, you have the right to appeal. You can also appeal if your plan stops or reduces a service you have been getting. If your plan says the service you want is “not medically necessary,” this explains how to appeal that determination (June 2024)
How to Obtain Mental Health Services and Substance Use Treatment in Pennsylvania
A guide from the Pennsylvania Health Law Project explaining how to obtain Mental Health Services and Drug & Alcohol Services under various programs in Pennsylvania. [PDF] (September 2024)
Medicaid Health Insurance Premium Payment Program (HIPP)
Medicaid Health Insurance Premium Payment Program (HIPP) was developed to help families with at least one person enrolled in Medicaid pay for private health insurance through an employer.
Medical Assistance Copayments - A Factsheet for Consumers
Fact sheet on the law when you cannot afford to pay your medical co-pays for Medical Assistance benefits. If you cannot afford the co-pay, your pharmacist or doctor CANNOT refuse to give you medications or refuse to treat you. Tell your healthcare provider if you cannot afford to pay. Your provider must treat you, but you will still owe the provider the co-pay. (May 2020)
Medical Assistance Eligibility Manual
Information from the Pennsylvania Health Law Project on the eligibility requirements for Medical Assistance benefits and how to establish eligibility for the benefits. (April 2020)
Medical Assistance for Workers with Disabilities (MAWD) - A Guide to Eligibility
Medical Assistance for Workers with Disabilities (MAWD) is a state health insurance program for people who are working and have a disability or serious health condition. MAWD is often a good option for people who make too much money to qualify for other categories of Medical Assistance (MA or Medicaid) but who nonetheless need health insurance. MAWD provides comprehensive health insurance coverage and as compared to other MA programs, has high income and resource limits. MAWD also has flexible work and disability requirements. This guide explains each MAWD eligibility requirement in depth and tells you how to apply for MAWD coverage. (January 2025)
Pennie - Pennsylvania's Health Care Marketplace
Pennie provides information on health care coverage available and how to sign up. All Pennsylvanians can search and choose coverage from November to January 15. After January 15th, folks who experience a Qualifying Life Event are still eligible to apply for financial assistance and shop for health insurance. Visit their website to learn more on qualifying life events.
Q&A: What Congress’ Latest Healthcare Cuts Mean for Pennsylvania October 2025
Update from Pennsylvania Health Law Project, Community Legal Services and Pennsylvania Health Access Network about the latest health care changes enacted by Congress and how these changes will affect Pennsylvanians. Included are a fact sheet and the recording of a webinar on the topic presented on October 7, 2025. (October 2025)
Reminder! Keep Your Medicaid Case File Up to Date
This information from the Pennsylvania Health Law Project explains how to update your case file information with Medicaid. If you are on Medicaid now, be sure to update your contact information, like mailing address and phone number, with the County Assistance Office. This will help ensure you get important updates and renewal paperwork in the mail and by phone. (September 29, 2025)
What You Should Know About Your House When You Enter a Nursing Home or Receive Care at Home
This brochure is for anyone who owns a home and may receive Medical Assistance to pay for their care in a nursing home or in the community.
PA Health Law Project Toll-Free Helpline - Call: 1-800-274-3258
The PA Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call the PHLP Helpline at 1-800-274-3258 or 1-866-236-6310 TTY or e-mail the PHLP at staff@phlp.org. Information from the PHLP is also available online at www.phlp.org. The Toll Free Helpline is open on Mondays and Wednesdays beginning at 8:00 AM Eastern.
MAWD or Marketplace? - What Pennsylvanians with Disabilities Need to Know About Choosing Health Insurance Coverage
Information on the selection of medical insurance by persons eligible for Medical Assistance for Workers with Disabilities (MAWD). Today, people with serious health issues and persons with disabilities who are working or may be able to work, can choose between Marketplace health insurance and MAWD. Includes eligibility requirements for each program, how to apply and highlights factors to consider when choosing coverage. (2015)
Medical Assistance for Workers with Disabilities (MAWD) - A Guide to Eligibility
Medical Assistance for Workers with Disabilities (MAWD) is a state health insurance program for people who are working and have a disability or serious health condition. MAWD is often a good option for people who make too much money to qualify for other categories of Medical Assistance (MA or Medicaid) but who nonetheless need health insurance. MAWD provides comprehensive health insurance coverage and as compared to other MA programs, has high income and resource limits. MAWD also has flexible work and disability requirements. This guide explains each MAWD eligibility requirement in depth and tells you how to apply for MAWD coverage. (January 2025)
Fact Sheet: Medical Assistance Transportation Program (MATP)
The Medical Assistance Transportation Program (“MATP”) is available to any Medical Assistance (“MA”) enrolled consumer who needs help with non-emergency transportation to and from MA-covered health care services or treatments. This information from the Pennsylvania Health Law Project explains the transportation services available through the PA Medical Assistance program. [PDF] (April 2013)
Benefits Check Up for Seniors
BenefitsCheckUp connects older adults and people with disabilities to programs that can help them afford daily expenses, live healthy, and stay independent. This free tool makes it easy to find programs that can boost your budget—then shows you how to learn more and apply online. See what's available in your area by entering your ZIP code on the site.
Benefits.gov
Benefits.gov is the official benefits website of the U.S. government whose mission is to increase citizen access to benefit information, while reducing the expense and difficulty of interacting with the government. It is a free, online confidential tool that helps you find government benefits you may be eligible to receive. Use the benefit finder tool or search by category to learn which benefits you and your family may be eligible for and learn how to apply for what you qualify for.
COMPASS
COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information, including SNAP, TANF, Medicaid, LIHEAP and other social service programs.
Pennie - Pennsylvania's Health Care Marketplace
Pennie provides information on health care coverage available and how to sign up. All Pennsylvanians can search and choose coverage from November to January 15. After January 15th, folks who experience a Qualifying Life Event are still eligible to apply for financial assistance and shop for health insurance. Visit their website to learn more on qualifying life events.
Reminder! Keep Your Medicaid Case File Up to Date
This information from the Pennsylvania Health Law Project explains how to update your case file information with Medicaid. If you are on Medicaid now, be sure to update your contact information, like mailing address and phone number, with the County Assistance Office. This will help ensure you get important updates and renewal paperwork in the mail and by phone. (September 29, 2025)
A Guide to Public Benefits
The Pennsylvania Legal Aid Network provides this guide to some programs that are funded by the government to provide help to individuals and families during times of need.
Fact Sheet: Medical Assistance Transportation Program (MATP)
The Medical Assistance Transportation Program (“MATP”) is available to any Medical Assistance (“MA”) enrolled consumer who needs help with non-emergency transportation to and from MA-covered health care services or treatments. This information from the Pennsylvania Health Law Project explains the transportation services available through the PA Medical Assistance program. [PDF] (April 2013)
GLP-1 Coverage Under Pennsylvania Medicaid
Effective January 1, 2026: Pennsylvania Medicaid no longer covers GLP-1 medications prescribed for weight loss for adults age 21 and over. More information on changes to coverage for GLP-1 medication can be found in this resource from the Pennsylvania Health Law Project.
How to Appeal a Denial in Community HealthChoices
If your Community HealthChoices (CHC) managed care plan denies your request for a service, such as personal assistance services, you have the right to appeal. You can also appeal if your plan stops or reduces a service you have been getting. If your plan says the service you want is “not medically necessary,” this explains how to appeal that determination (June 2024)
How to Obtain Mental Health Services and Substance Use Treatment in Pennsylvania
A guide from the Pennsylvania Health Law Project explaining how to obtain Mental Health Services and Drug & Alcohol Services under various programs in Pennsylvania. [PDF] (September 2024)
MAWD or Marketplace? - What Pennsylvanians with Disabilities Need to Know About Choosing Health Insurance Coverage
Information on the selection of medical insurance by persons eligible for Medical Assistance for Workers with Disabilities (MAWD). Today, people with serious health issues and persons with disabilities who are working or may be able to work, can choose between Marketplace health insurance and MAWD. Includes eligibility requirements for each program, how to apply and highlights factors to consider when choosing coverage. (2015)
Medicaid Estate Recovery: A Primer (Video)
This video from Community Legal Services explains the basics of Medical Assistance ("Medicaid") Estate Recovery and answers important questions about the program. It explains what happens if you own a home and receive Medical Assistance to pay for care in a nursing home or in the community. Funding for this video was made possible by Philadelphia Corporation for Aging (PCA). (2014)
Medical Assistance Copayments - A Factsheet for Consumers
Fact sheet on the law when you cannot afford to pay your medical co-pays for Medical Assistance benefits. If you cannot afford the co-pay, your pharmacist or doctor CANNOT refuse to give you medications or refuse to treat you. Tell your healthcare provider if you cannot afford to pay. Your provider must treat you, but you will still owe the provider the co-pay. (May 2020)
Medical Assistance Eligibility Manual
Information from the Pennsylvania Health Law Project on the eligibility requirements for Medical Assistance benefits and how to establish eligibility for the benefits. (April 2020)
Medical Assistance for Workers with Disabilities (MAWD) - A Guide to Eligibility
Medical Assistance for Workers with Disabilities (MAWD) is a state health insurance program for people who are working and have a disability or serious health condition. MAWD is often a good option for people who make too much money to qualify for other categories of Medical Assistance (MA or Medicaid) but who nonetheless need health insurance. MAWD provides comprehensive health insurance coverage and as compared to other MA programs, has high income and resource limits. MAWD also has flexible work and disability requirements. This guide explains each MAWD eligibility requirement in depth and tells you how to apply for MAWD coverage. (January 2025)
PA Health Law Project Toll-Free Helpline - Call: 1-800-274-3258
The PA Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call the PHLP Helpline at 1-800-274-3258 or 1-866-236-6310 TTY or e-mail the PHLP at staff@phlp.org. Information from the PHLP is also available online at www.phlp.org. The Toll Free Helpline is open on Mondays and Wednesdays beginning at 8:00 AM Eastern.
Q&A: What Congress’ Latest Healthcare Cuts Mean for Pennsylvania October 2025
Update from Pennsylvania Health Law Project, Community Legal Services and Pennsylvania Health Access Network about the latest health care changes enacted by Congress and how these changes will affect Pennsylvanians. Included are a fact sheet and the recording of a webinar on the topic presented on October 7, 2025. (October 2025)
Reminder! Keep Your Medicaid Case File Up to Date
This information from the Pennsylvania Health Law Project explains how to update your case file information with Medicaid. If you are on Medicaid now, be sure to update your contact information, like mailing address and phone number, with the County Assistance Office. This will help ensure you get important updates and renewal paperwork in the mail and by phone. (September 29, 2025)
Special Needs Trust
Northwestern Legal Services provides an overview of what a Special Needs Trust is, who needs one, and how to get one. (October 2018)
What You Should Know About Your House When You Enter a Nursing Home or Receive Care at Home
This brochure is for anyone who owns a home and may receive Medical Assistance to pay for their care in a nursing home or in the community.
COMPASS
COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information, including SNAP, TANF, Medicaid, LIHEAP and other social service programs.
Estate Recovery Program
Information from the Pennsylvania Department of Human Services on the Estate Recovery Program that enables the Commonwealth of Pennsylvania to recover from the estate of individuals who were 55 years of age or older at the time nursing facility services or home and community-based services were received.
Medicaid Health Insurance Premium Payment Program (HIPP)
Medicaid Health Insurance Premium Payment Program (HIPP) was developed to help families with at least one person enrolled in Medicaid pay for private health insurance through an employer.
Medicaid/Medical Assistance
This is the section of the Pennsylvania Department of Human Services website with information for people applying for or currently receiving Medicaid, also known as Medical Assistance (MA).
Medical Assistance Benefits for Workers with Disabilities
Information on Medical Assistance for Workers with Disabilities (MAWD) from the Pennsylvania Department of Human Services. MAWD lets Pennsylvanians with disabilities take a fulfilling job, earn more money and still keep their full medical coverage. With MAWD you can keep Medical Assistance while you work, even if your earnings increase above the limits for other Medical Assistance programs.
Pennie - Pennsylvania's Health Care Marketplace
Pennie provides information on health care coverage available and how to sign up. All Pennsylvanians can search and choose coverage from November to January 15. After January 15th, folks who experience a Qualifying Life Event are still eligible to apply for financial assistance and shop for health insurance. Visit their website to learn more on qualifying life events.
Pennsylvania Breast & Cervical Cancer Early Detection Program
Information on the Pennsylvania Breast & Cervical Cancer Early Detection Program, which is a free breast and cervical cancer early detection program of the Pennsylvania Department of Health. It is funded by the Department of Health and through a grant the Department receives from the Centers for Disease Control and Prevention.
How to Appeal a Medical Assistance Denial of Assistive Technology
This manual from Disability Rights Pennsylvania will explain your rights when Medical Assistance, including your Medical Assistance managed health care plan, denies prior authorization or denies a program exception. This includes an approval of something less or different than what your doctor prescribed. [PDF] (January 2018)