Pennsylvania Medicaid Income Limits 2026: Who Qualifies
Who can get Pennsylvania Medical Assistance in 2026, the income limits in dollars, and how to apply — in plain English.
Figures cite official government sources (linked by each table). Last verified July 17, 2026 · Effective period: Calendar 2026.
Pennsylvania expanded Medicaid, so adults qualify for Pennsylvania Medical Assistance in 2026 with income up to 138% of the Federal Poverty Level — about $1,835 per month for a single person and $3,795 for a family of four, with no asset test.
Key takeaways
- Qualify as an adult with income up to $1,835/month (1 person) or $3,795 (family of 4) — 138% FPL.
- Skip the asset test — MAGI Medicaid counts income only, not savings.
- Enroll any time — Medicaid has no open-enrollment window.
- Apply for kids regardless: children's limits run far higher than 138% FPL.
- Note the timing: the federal Medicaid community-engagement (work) requirement is generally scheduled to begin January 1, 2027, not 2026 — confirm Pennsylvania's date with its Medicaid agency.
Pennsylvania adult income limits by household size (2026)
| Household size | Monthly limit (138% FPL) | Annual limit |
|---|---|---|
| 1 | $1,835 | $22,020 |
| 2 | $2,489 | $29,868 |
| 3 | $3,142 | $37,704 |
| 4 | $3,795 | $45,540 |
| 5 | $4,448 | $53,376 |
| 6 | $5,101 | $61,212 |
| 7 | $5,755 | $69,060 |
| 8 | $6,408 | $76,896 |
Source: Pennsylvania DHS — Medical Assistance — 2026 federal poverty guidelines.
These figures are derived from the federal poverty guidelines using MAGI (Modified Adjusted Gross Income). Confirm the exact figure with Pennsylvania Department of Human Services (DHS).
Who qualifies for Pennsylvania Medical Assistance
Pennsylvania expanded Medicaid: adults qualify for Medical Assistance up to 138% of the Federal Poverty Level.
Children qualify for Medical Assistance/CHIP at higher income levels; PA CHIP has no upper income cap (higher incomes pay premiums).
Medicaid for people who are aged, blind, or disabled in Pennsylvania is based on state-specific non-MAGI rules. Income limits, resource limits, medically-needy/spend-down programs, and long-term-care standards vary by program — there is no single nationwide figure. Confirm the current limits with Pennsylvania Department of Human Services (DHS). Low-income Medicare beneficiaries can also get help with premiums through Medicare Savings Programs.
How Medicaid interacts with other benefits
- SSI: an SSI award brings Medicaid automatically or via a streamlined process in Pennsylvania.
- SNAP: separate tests, one application — the same portal (compass.state.pa.us) handles both.
- Marketplace: above 138% FPL, subsidies through Pennie take over.
- Medicare: dual-eligible seniors get premium and cost-sharing help through Medicaid.
Where to apply
- Apply through the state Medicaid/benefits portal first — Pennsylvania Department of Human Services (DHS), compass.state.pa.us, or by phone at 800-692-7462.
- Pennsylvania runs its own Marketplace — Pennie (pennie.com) — which screens for Medicaid and handles Marketplace plans if you're over the limit.
Frequently asked questions
What is the Medicaid income limit in Pennsylvania for 2026?
Adults qualify for Pennsylvania Medical Assistance with income up to 138% of the Federal Poverty Level: about $1,835 per month for one person and $3,795 for a family of four in 2026.
Does Pennsylvania Medicaid have an asset test?
Not for MAGI groups — adults under 138% FPL, children, and pregnant applicants face no asset limit. Non-MAGI Medicaid (aged, blind, disabled, and long-term care) uses state-specific resource rules that vary by program — confirm the current figure with Pennsylvania Department of Human Services (DHS).
Can children get Medicaid in Pennsylvania if parents earn too much?
Children qualify for Medical Assistance/CHIP at higher income levels; PA CHIP has no upper income cap (higher incomes pay premiums). There's no harm in applying — children are evaluated separately from adults.
Does SSI qualify me for Medicaid in Pennsylvania?
Yes — SSI recipients ($994/month federal rate in 2026) get Medicaid automatically or via a streamlined process in Pennsylvania.
Is there an enrollment deadline for Medicaid in Pennsylvania?
No. Medicaid enrollment is open year-round — you can apply any month, and coverage can start retroactively up to 3 months before your application in many cases.
How do I apply for Medicaid in Pennsylvania?
Apply online at compass.state.pa.us, by phone at 800-692-7462, or at a local office of Pennsylvania Department of Human Services (DHS). Pennsylvania runs its own Marketplace, Pennie (pennie.com), which also screens for Medicaid.