Medical Assistance

Legal Information

Other Health Problems

Disabled Child with Mom

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.

How to Obtain Mental Health and Drug & Alcohol Services in Pennsylvania

Booklet from the Pennsylvania Health Law Project explaining how to obtain Mental Health Services and Drug & Alcohol Services under various programs in Pennsylvania. [PDF]

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)

Community HealthChoices Toolkit

Community HealthChoices (CHC) is a new waiver program for individuals over 21 years old with a disability who previously received services through the Independence, CommCare, or Aging Waivers. This toolkit was developed by the Pennsylvania Assistive Technology Foundation, in collaboration with the Pennsylvania Health Law Project to provide information on CHC.

Community HealthChoices (Video)

This video from the Pennsylvania department of Human Services explains the new Community HealthChoices program. Community HealthChoices will coordinate your health care coverage to improve the quality of your health care experience — serving more people in communities rather than in facilities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.

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.

Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency

Answers to some frequently asked questions about medical coverage from the Centers for Medicare and Medicaid Services related to the End of the COVID-19 Public Health Emergency. While some FAQs are relevant for all programs, including Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and private insurance, other questions are program specific as indicated.

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.

COMPASS - Apply for Public Benefits and Services from the Commonwealth of Pennsylvania

Pennsylvania residents can apply for a variety of programs offered by the PA Department of Human Services, including public assistance, food stamps, health care coverage, energy assistance and other social service programs at this site

Application for cash assistance, SNAP and Medical Assistance Benefits

You can apply for cash assistance, SNAP and Medical Assistance benefits online with Pennsylvania Department of Human Services. Paper forms can also be printed from the website.

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.

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.

Facts About MAWD (Medical Assistance Benefits for Workers with Disabilities) (Video)

This video from Pennsylvania Health Law Project provides information on the Medical Assistance Benefits for Workers with Disabilities (MAWD) program which provides low-cost health insurance to people who are disabled and working.

Medical Assistance for Workers with Disabilities

Information from the Pennsylvania Health Law Project on the MAWD (Medical Assistance for Workers with Disabilities) Program which allows qualified persons to purchase Medical Assistance if their income does not exceed 250% of the Federal Poverty Level. [PDF]

Medical Assistance for Workers with Disabilities (MAWD) - A Guide to Eligibility

Information from the Pennsylvania Health Law Project about how to qualify for Medical Assistance for Workers with Disabilities (also called “MAWD”), a state health insurance program for individuals who have chronic health problems and are working. (December 2019)

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.

Completing the Employability Assessment Form (PA 1663) - A Guide for Healthcare Providers

Information for health care providers explaining how to effectively complete the Employability Assessment Form to verify your patient's health conditions, illnesses, and/or disabilities to support your patient’s application for Medical Assistance.

Medical Assistance for Workers with Disabilities: What is MAWD?

MAWD is Medical Assistance for people working with disabilities. For a low monthly premium you may see savings on out-of-pocket costs for doctor visits, durable medical equipment, prescription drugs, emergency care, mental health services, drug and alcohol treatment, hospital stays, rehabilitation services, and medical transportation services. (October 2018)

Fact Sheet: Medical Assistance Transportation Program (MATP)

Information about transportation services available through the PA Medical Assistance program. [PDF]

Understanding the Medical Assistance Transportation Program

Information about the Medical Assistance Transportation Program (MATP). The program is available to any Medical Assistance consumer who needs help with non-emergency transportation to and from health care services or treatments.

COMPASS - Apply for Public Benefits and Services from the Commonwealth of Pennsylvania

Pennsylvania residents can apply for a variety of programs offered by the PA Department of Human Services, including public assistance, food stamps, health care coverage, energy assistance and other social service programs at this site

Application for cash assistance, SNAP and Medical Assistance Benefits

You can apply for cash assistance, SNAP and Medical Assistance benefits online with Pennsylvania Department of Human Services. Paper forms can also be printed from the website.

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.

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.

COMPASS - Apply for Public Benefits and Services from the Commonwealth of Pennsylvania

Pennsylvania residents can apply for a variety of programs offered by the PA Department of Human Services, including public assistance, food stamps, health care coverage, energy assistance and other social service programs at this site

Community HealthChoices

Community HealthChoices (CHC) is Pennsylvania’s mandatory managed care program for individuals who are dually eligible for both Medical Assistance and Medicare, older adults, and individuals with physical disabilities — serving more people in communities while giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.

Community HealthChoices (Video)

This video from the Pennsylvania department of Human Services explains the new Community HealthChoices program. Community HealthChoices will coordinate your health care coverage to improve the quality of your health care experience — serving more people in communities rather than in facilities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.

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.

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.

Office of Medical Assistance Programs

Section of the Pennsylvania Department of Human Services website dedicated to the Office of Medical Assistance Programs which administers and oversees the Medical Assistance program in Pennsylvania.

Pennsylvania Health Insurance Premium Payment (HIPP) Program

Information from the Pennsylvania Department of Human Services on the PA Health Insurance Premium Payment Program. The Health Insurance Premium Payment (HIPP) Program is a program developed to help families, who have at least one person enrolled in Medical Assistance (MA), pay for private health insurance through an employer.

Health Care/Medical Assistance

This is the section of the Pennsylvania Department of Human Services website with information for people applying for or currently receiving Medical Assistance.

Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency

Answers to some frequently asked questions about medical coverage from the Centers for Medicare and Medicaid Services related to the End of the COVID-19 Public Health Emergency. While some FAQs are relevant for all programs, including Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and private insurance, other questions are program specific as indicated.

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.

STAY CONNECTED with the Lifeline Telephone and Broadband Assistance Program

The Lifeline Program is a federal government benefit that provides eligible low-income consumers a monthly discount on their phone or internet bill. The benefit can be used for voice (telephone), Broadband internet Access Service (or BIAS, usually called internet service), or a combined telephone/internet service product from a landline or wireless provider.

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)

Medicaid Moving Forward

Information from the Kaiser Family Foundation providing an overview of the Medicaid program and its place in the total health care system.

Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency

Answers to some frequently asked questions about medical coverage from the Centers for Medicare and Medicaid Services related to the End of the COVID-19 Public Health Emergency. While some FAQs are relevant for all programs, including Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and private insurance, other questions are program specific as indicated.

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