In Pennsylvania, eligible seniors can receive affordable health care services via Medicaid, known as Medical Assistance (MA). This program provides recipients with standard benefits, including checkups, immunizations, prescription drugs, emergency room care and mental health treatment.
The Medical Assistance program has specific eligibility guidelines that seniors must fulfill. To receive coverage, they must be a:
- Resident of Pennsylvania
- U.S. citizen, lawfully admitted alien or refugee
Pennsylvania also has specific income requirements. Most seniors will fall under the program’s Non-Money Payment (NMP) Medical Assistance category. Designed for residents who are aged, blind or disabled, this category is dependent on Supplemental Security Income (SSI). To meet the financial requirements, seniors cannot have income that exceeds:
- $2,000 (individual)
- $3,000 (two people)
To apply to Medical Assistance, Delaware County seniors can use the state’s online tool for health and human service programs, Compass. Once they’ve turned in their application, they should receive a response in the mail within 30 days.
Everyone enrolled in the Medical Assistance program receives a managed care provider. Seniors are automatically enrolled in Community HealthChoices (CHC), a managed care program designed to serve the needs of aging adults. Delaware County seniors can choose a plan from the health care providers serving Southeast Pennsylvania, which include:
- Aetna Better Health
- Health Partners of Philadelphia Inc.
- Keystone First Health Plan
- United Healthcare Community Plan
Pennsylvania is implementing the CHC program over several years. Seniors in Southeast territories will receive all of their CHC benefits during Phase II of the transition, which was completed January 2019. CHC gives seniors access to the services that used to be conferred via the Office of Long-Term Living waivers. CHC cannot be used to cover the costs of assisted living, but seniors can use the available long-term benefits while living in assisted living facilities.
Services include:
- Benefits counseling
- Community transition
- Nonmedical transportation
- Specialized medical equipment and supplies
- Personal assistance
For more information about Medicaid or its waivers, please call (800) 692-7462 or apply online with COMPASS.