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Medical Assistance Programs in Pennsylvania

Pennsylvania has many medical assistance programs available for low-income households. This is very important, as under the Affordable Care Act, all Pennsylvania residents are required to have some form of health care coverage. Any individual that does not have health insurance is forced to pay a hefty fine. Not only do medical assistance programs help avoid any fines, but it insures that the beneficiary has the chance to receive medical care whenever needed.

Because there are so many different medical assistance programs, it can actually be very overwhelming to pick a plan. Fortunately, applicants can go through COMPASS to find which Pennsylvania medical assistance programs they are eligible for. COMPASS is a universal health care application, which not only helps with determining medical assistance program eligibility in Pennsylvania, but it also allows applicants to directly apply for assistance. Having a universal application simplifies much of the process, and helps to eliminate some of the paperwork previously involved with applying for medical assistance. While COMPASS is very useful for the application process, it is important that the applicants understand exactly what medical assistance programs they are applying for.

Health Insurance Marketplace in Pennsylvania

While COMPASS is great for applying to Pennsylvania medical assistance programs, it does not represent all of the available programs. As part of the Affordable Care Act, all states were required to make a health insurance exchange where applicants could look for plans. States could either make their own exchanges, or use one provided by the federal government. As of writing, Pennsylvania uses the federal health exchange.

Applicants can go directly onto the health insurance exchange to complete their application and enroll for plans directly through the marketplace. In addition, the marketplace lists what sort of cost sharing assistance is available for the applicant, typically in the form of cost reductions or tax credits. Applicants are encouraged to apply through COMPASS as well as the health insurance marketplace to find all the possible insurance plans in their area.

Pennsylvania Medicaid

Medicaid is one of the largest medical assistance programs available in the United States. Medicaid was formed by the federal government, but every state is responsible for administering it. The main purpose of the program is to provide medical assistance for beneficiaries who cannot reasonably pay for their own health insurance. The primary beneficiaries include low-income households, residents with a disability and the elderly. In Pennsylvania, Medicaid coverage applies for physical health options as well as both mental health and substance abuse services.

Pennsylvania Medical Assistance Benefits for Workers with Disabilities (MAWD)

One of the issues that residents with disabilities face is balancing their insurance eligibility with their work. While there are many medical assistance programs available for disabled residents, one of the common requirements for these programs state that the beneficiary cannot be working. This puts disabled beneficiaries that can still work in a difficult position. Due to their conditions, these beneficiaries require high quality insurance, which they might not be able to afford through their work. MAWD was created to eliminate this problem. Under MAWD, disabled beneficiaries are able to work a job while still receiving the high-quality medical assistance normally provided through disability insurance. The insurance does come at a cost, but the premium is only five percent of the countable monthly income for the beneficiary.

Pennsylvania Medicare

Medicare is sometimes used interchangeably with Medicaid, but the two are actually very different programs. Unfortunately, the similar name often leads to confusion. Medicare is a medical assistance program which provides insurance for anyone that is at least 65 years old, or residents with certain disabilities. Medicare benefits are divided into two categories, Part A and Part B. Both parts offer slightly different coverage, and also have different costs. The most common type of Medicare is Part A. The reason for this is the eligibility requirements. Anyone that has paid Medicare taxes for at least 10 years do not have to pay any monthly charges for Part A coverage. Participants can also choose from other plans, which includes a Part C and D.

Pennsylvania Children’s Health Insurance Program (CHIP)

CHIP provides medical assistance for children and teenagers that are not enrolled under any other insurance plans. CHIP is important for parents who do not have an insurance that applies to their children, and cannot afford to purchase separate plans to cover their children. Families participating in CHIP receive heavy discounts. In most situations, CHIP is completely free. As long as all the financial eligibility requirements are meant, teenagers can receive CHIP coverage until they turn 19.

Parents that need additional assistance applying for CHIP can go through RHD CHIPRA. RHD CHIPRA is a free program which provides a family benefits advocate for any applicants that are having trouble applying for CHIP benefits.

Breast and Cervical Cancer Prevention and Treatment (BCCPT) in Pennsylvania

Unlike the previously mentioned programs, BCCPT does not provide insurance. In fact, one of the requirements is that applicants cannot have any insurance. BCCPT provides health care coverage for women who need treatment for either breast or cervical cancer. This includes pre-cancerous conditions as well.

Pennsylvania HealthyWoman Program (HWP)

HWP is often associated with BCCPT. Like BCCPT, it does not provide general health insurance coverage. HWP provides free cancer screening services to low-income or uninsured women in Pennsylvania. The program is primarily intended for women between the ages of 40 and 64, but younger women may qualify if they show any relevant symptoms.