What is the monthly income limit for Medicaid in PA? The answer depends on your age, household size, and health situation. Most adults ages 19 to 64 can qualify with an income up to $1,835 per month. Families with children and pregnant individuals may qualify at much higher limits.
Pennsylvania Medicaid covers several different groups. Each group has its own income rules. Read the full breakdown below to find the limit that applies to you.
1. What Is the Monthly Income Limit for Medicaid in PA?
The monthly income limit for Medicaid in PA depends on your age, household size, and the type of coverage you need.
For most working-age adults, the limit is $1,835 per month for a single person. Families, pregnant individuals, seniors, and people who need long-term care follow different rules.
Pennsylvania calls its Medicaid program Medical Assistance (MA). The state uses the federal poverty guidelines to set each category’s limit. Check your category below to find your number.
Income Limits for Standard Adults and Families (MAGI)
MAGI stands for Modified Adjusted Gross Income. Pennsylvania uses MAGI rules for most adults and families.
1. Single Adults Ages 19–64
Single adults qualify under the 138% Federal Poverty Level (FPL) expansion. The cap is $1,835 per month.
| Household Size | Monthly Income Limit |
| 1 person | $1,835 |
| 2 people | $2,484 |
| 3 people | $3,133 |
| 4 people | $3,782 |
2. Pregnant Individuals and Children
Pennsylvania protects families with higher limits, up to 319% FPL. A family of three can earn up to $6,900 per month and still qualify for children’s Medical Assistance.
(Income guidelines may change annually and can vary depending on household composition and program rules)
| Coverage Type | Household of 2 | Household of 3 | Household of 4 |
| Pregnant + Children under 1 | $3,878 | $4,886 | $5,895 |
| Children ages 1 to 5 | $2,856 | $3,598 | $4,341 |
| Children ages 6 to 18 | $2,433 | $3,065 | $3,698 |
Many families assume they earn too much. Check your household size before ruling yourself out.
Income Limits for Long-Term Care and Waivers (Non-MAGI)
Non-MAGI rules apply to seniors and people with disabilities who need nursing home care or Home and Community-Based Services (HCBS).
1. The $2,982 Monthly Cap
A single applicant needing nursing home care or HCBS waiver services faces a monthly income cap of $2,982. For many HCBS and nursing home Medicaid categories, eligibility calculations focus primarily on the applicant’s income, although spousal protections and allocation rules may still apply.
| Applicant Type | Monthly Income Limit | Resource Limit |
| Single (HCBS or Nursing Home) | $2,982 | $8,000 |
| Married | Spousal rules apply | Higher limit applies |
2. The Qualified Income Trust (QIT)
Going over $2,982 per month does not mean disqualification. Pennsylvania allows applicants to use a Qualified Income Trust (QIT), also called a Miller Trust.
How a QIT works:
- The applicant opens a legal trust account.
- Income above $2,982 flows into the trust each month.
- Trust funds pay toward care costs.
- Countable income drops below the limit.
- The applicant may then meet the income requirements for Medical Assistance eligibility.
A QIT must meet Pennsylvania’s legal standards. Contact your County Assistance Office or an elder law attorney to set one up correctly.
2. Rules for the Aged, Blind, and Disabled (ABD)
Seniors ages 65 and older and individuals with disabilities who do not need nursing home care fall under the ABD Medicaid category.
Income limits for ABD align closely with federal Supplemental Security Income (SSI) thresholds. For 2026, the standard limit is $1,304 per month for a single person and $1,763 per month for a married couple.
| Applicant Type | Monthly Income Limit | Resource Limit |
| Single | $1,304 | $2,000 |
| Married | $1,763 | $3,000 |
Pennsylvania offers additional Medicaid-related support programs, including Healthy Horizons and Medicare cost-sharing assistance for qualifying individuals. These individuals may receive full Medicaid coverage plus help paying Medicare Part A and Part B premiums.
If your income exceeds the ABD limit but falls below the long-term care cap, you may still qualify for a different program. You can check your options through the PA COMPASS portal or by calling 1-866-550-4355.
>>> Read more: Does Medicaid Cover Physical Therapy In 2026? Benefits and Eligibility
3. How to Apply for PA Medical Assistance
Pennsylvania offers four ways to apply for Medical Assistance. You can start at any time. Most standard applications are processed within approximately 30-45 days.
Prepare Your Documents
Gather these items before you apply. Having them ready prevents delays.
- Proof of identity: Driver’s license, state-issued ID, or birth certificate
- Proof of residence: Lease agreement, mortgage statement, or a utility bill in your name
- Income verification: Tax returns or 30 days of recent pay stubs
- Household details: Social Security Numbers and dates of birth for everyone applying
- Assets or resources: Bank account statements, vehicle information, and life insurance documents (if applicable)
Application Methods
You can choose one of four application methods below to apply for Medicaid in PA.
1. Online (Fastest)
Apply through the official PA COMPASS portal at compass.state.pa.us. You can create an account, upload documents, and track your application status in one place.
2. By Phone
Call the PA Consumer Service Center at 1-866-550-4355. A representative will walk you through the application over the phone.
3. By Mail or Fax
Download form PA 600 HC from the Pennsylvania DHS website. Fill it out and mail or fax the completed form to your local County Assistance Office.
4. In Person
Visit your local County Assistance Office (CAO). Staff can help you complete the application on the spot.
Once you submit your application, the CAO will make an eligibility decision within 30 days.
>>> Read more: Medicaid Redetermination Requirements: How to Renew in 2026
4. Unlock Communication Benefits With Your PA Medical Assistance
Pennsylvania Medical Assistance does more than cover your health care. Your Medicaid enrollment may also qualify you for a free federal phone benefit at no extra cost.
The Federal Lifeline Program
The Lifeline program is a federal assistance program managed by the FCC. Lifeline helps low-income households afford basic phone service and internet service.
If you already receive PA Medical Assistance, you may automatically meet the eligibility requirements for Lifeline. Other qualifying ways based on your income limit, or other government programs (SNAP, SSI, Section 8, and Veterans Pension).
Lifeline provides a monthly discount on phone or internet service:
- $9.25 per month for eligible low-income households
- $34.25 per month for households located on qualifying Tribal lands
Additionally, the Lifeline service is non-transferable and limited to one service per household. And the eligibility may vary by state and program.
Please keep in mind that the program does not handle the process of giving the benefit by itself. Instead, it partnered with eligible communication carriers to deliver this benefit to those in need.
And those carriers, like Cintex Wireless, in many cases, take a step further and offer to eligible households a functional device along with the Lifeline service plan, which makes the support more practical and accessible for everyday use.
When applying to these Lifeline providers, eligible PA residents may expect to receive:
- A free 5G smartphone
- $0 monthly service with no contract
- Unlimited talk and text
- 5G data each month
UPDATE: Cintex Wireless is officially merging with AirTalk Wireless. This partnership provides customers with a stronger network, quicker application processing times, and significantly larger monthly rewards.
How to Apply
Applying takes just a few minutes. Follow these steps:
- Visit the Cintex Wireless or AirTalk Wireless website and enter your ZIP code to check service availability in your area
- Select a plan and choose your device
- Fill in the essential information. In some cases, you might be required to upload additional documentation.
- Submit your application and wait for the result. Once approved, your device will be shipped directly to your address.
IMPORTANT: The government does not subsidize devices. Lifeline programs cover basic service costs only. Free or discounted devices, upgrade plans, or top-ups are exclusive benefits provided by Cintex and AirTalk Wireless as part of promotional offers. Terms and conditions apply. Limited-time promotion—offers vary by state, stock availability, and eligibility.
5. FAQs
Q1. What is the asset limit for Medicaid in PA?
For standard adults ages 19 to 64, Pennsylvania does not enforce an asset limit under MAGI rules. For Long-Term Care and elderly applicants, countable assets are capped at $2,000 for a single person or $8,000 for HCBS waiver applicants, depending on the specific waiver and applicant situation.
Q2. Does PA Medicaid have a look-back period?
Yes. Pennsylvania enforces a 60-month (5-year) look-back period for Long-Term Care Medicaid. The state reviews all financial transactions during that period. Transferring money or property to qualify for nursing home coverage can result in a penalty period.
Q3. What is the medically needy spend-down in PA?
Pennsylvania offers a medically needy program for people who earn above the standard Medicaid income limits. You can deduct outstanding medical bills from your excess income until your countable income drops to the required threshold. Once you reach that level, Medical Assistance coverage begins.
Conclusion
What is the monthly income limit for Medicaid in PA? Single adults may qualify with income up to approximately $1,835 per month. Families, pregnant individuals, and seniors each have separate rules worth checking. Do not assume you earn too much before you verify your category. Many Pennsylvania residents qualify and do not know it yet.
You can start your PA Medical Assistance application through the PA COMPASS portal or call 1-866-550-4355 today. If you already receive Medicaid, you may also qualify for a free Lifeline smartphone plan through Cintex Wireless or AirTalk Wireless at no extra cost.
