What is the difference between Medicaid and medical assistance in PA?
Asked by: Whitney Swift DVM | Last update: March 18, 2025Score: 5/5 (23 votes)
What is the maximum income to qualify for medical assistance in PA?
If the applicant has gross income which is $2,829 or less, then the person's resource limit is $8,000. Examples of “countable assets” include checking and savings accounts, stocks, bonds, brokerage accounts, and non-resident real estate. This income limit, now $2,829/month, normally changes on January 1st of each year.
What type of insurance is medical assistance in PA?
Pennsylvania's Medicaid program, also known as "Medical Assistance", provides comprehensive health care coverage for vulnerable populations and people with limited incomes. Historically, Medicaid was only available to narrow groups, such as low-income children and adults with disabilities.
What is the best Medicaid plan in PA?
If you plan on applying for Medicaid, the best Medicaid plan in the state is the Keystone plan, from Independence Blue Cross. I have helped multiple people sign up for Medicaid, and trust me, you're going to want that Keystone plan.
What does Medicaid cover for adults?
Mandatory benefits include services including inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services including prescription drugs, case management, physical therapy, and occupational therapy.
Pennsylvania Medicaid Planning - Long Term Care Programs
What does Medicaid pay for in PA?
Medicaid covers a broad range of physical and behavioral health services, including doctor visits when you're sick, preventive care like health screenings, vaccines, hospital stays, prescription medications, mental health and substance use disorder care, and more.
Does PA medical assistance cover prescriptions?
PA Health & Wellness covers prescription medications and certain over- the-counter (OTC) medications when ordered by a physician/clinician. The pharmacy program covers all outpatient drugs as defined by CMS. Some medications require prior authorization (PA) or have limitations on age, dosage, and maximum quantities.
How often does Medicaid check your bank account?
Medicaid agencies can check your account balances for bank accounts at any financial institution you've used in the past five years. They will check when you submit an application and on an annual basis, but checks can occur at any time.
What does the medical assistant do?
Medical assistants perform administrative and clinical tasks to keep the offices of health practitioners running smoothly. Some medical assistants spend a lot of time standing or walking as they visit patients. Others sit at a computer for much of the day to work on administrative tasks.
What is not covered by Medicaid?
Medicaid coverage can vary from state to state, but here are some common services and items that are typically not covered: Elective cosmetic procedures: Cosmetic surgeries and procedures, such as cosmetic dentistry and non-medical weight loss procedures, that are not medically necessary are typically not covered.
What happens if you make too much money while on Medicaid?
If you're over the Medicaid income limit, some states let you spend down extra income or place it in a trust to help you qualify for Medicaid. If you receive long-term care but your spouse doesn't, Medicaid will allow your spouse to keep enough income to avoid living in poverty.
How much money can you have in the bank on Medicaid in PA?
The MNO-MA asset limits are $2,400 for an individual and $3,200 for a couple. There is no additional asset disregard. 2) Asset Spend Down – Seniors who have assets over Medicaid's limit can still become asset-eligible by spending down extra assets on non-countable ones.
How long does it take to get approved for medical assistance in PA?
The CAO must make a decision on eligibility within 30 calendar days of the application filing date. If there is enough information to determine eligibility for Medical Assistance, the CAO must not delay authorization of Medical Assistance while waiting for verification of Cash Assistance eligibility.
What is the cheapest health insurance in PA?
- $411/mo. Highmark: Best overall. Highmark: Best overall.
- $349/mo. Ambetter: Cheapest Silver plan. Ambetter: Cheapest Silver plan.
- $327/mo. UPMC Health Plan: Cheapest Gold plan. UPMC Health Plan: Cheapest Gold plan.
Can Medicaid see your income?
Some states use a computerized system to cross reference a Medicaid applicant's reported income. For instance, in California, an electronic database, the Income Eligibility Verification System (IEVS), is used to match the income information provided by the applicant to other databases to verify it is accurate.
How do I protect my bank account from Medicaid?
One such option to protect assets is a Medicaid Trust. By placing some of your assets in an appropriate trust, you can protect them from Medicaid and have them not be counted when you are applying for benefits.
How much money can you have in the bank if you're on Medicare?
There is no limit on the amount of cash you can have with Medicare Part A. You do have to have paid taxes for 40 quarters (10 years) during your working lifetime and you have to be age 65 unless otherwise qualified due to a social security eligible disability.
Does PA medical assistance cover glasses?
Answer: Medical Assistance (MA) and CHIP pay for eye exams and glasses. ➢ Medical Assistance pays for as many replacement glasses and exams as needed. ➢ At a minimum, CHIP pays for one eye exam and at least two pairs of glasses a year, including a replacement pair if the eyeglasses are lost or broken.
Does PA Medicaid cover weight loss medication?
Pennsylvania's Medicaid program began covering the newer weight loss medications in 2023 when Wegovy was added to Medicaid's list of preferred drugs for the treatment of obesity. Since then, Medicaid has added two other medications for weight loss to its preferred drug list: Saxenda and Zepbound.
Can medical assistants give medications in PA?
Yes, medical assistants can give patients medications as long as they have been approved by a physician and the medical assistant is working under the supervision of a physician or nurse practitioner. Additionally, medical assistants can prepare medications, and explain medication instructions to patients.
Does PA Medicaid cover dental?
Adults enrolled in Medicaid are eligible for exams, x-rays, teeth cleanings, cavity fillings, dentures, extractions, and other surgical procedures and emergency services related to treatment for symptoms and pain. Some adults may be eligible for other dental services.
Does Medicaid cover an ambulance in PA?
Medicaid also covers the cost of emergency medical transportation for eligible individuals. Examples include having a heart attack or being seriously injured in a car accident.
How much money do you spend on Medicaid?
Other states with significant year-over-year spending increases included Washington ($4.1 billion), Illinois ($2.8 billion), and California ($2.4 billion).