Pennsylvania Medicaid for Seniors: Eligibility & Resource Rules

Medicaid is a state-operated, federally- and state-funded health insurance program that covers low-income elderly and disabled individuals, pregnant women and children. Pennsylvania's Medicaid program for the elderly has specific rules that must be met to become eligible and maintain eligibility.

Income and Resources

• For one elderly individual, the income limit is 300 percent of the Federal Benefit Rate (FBR). In 2010, this amount is $2,022. Resources, including cash on hand, stocks, bonds, mutual funds, bank accounts, non-resident property, IRA and Keogh accounts, and life insurance policies with a cash value greater than $1,500 count toward the resource limit of $2,000 for an individual. A benefits planner familiar with elder law and Medicaid rules may assist applicants to ensure that income and resource limits are met.

Transfer of Assets

• Any assets that are transferred for less than fair market value in the five-year period prior to submitting a Medicaid application may be counted towards income and resource limits. If you require Medicaid coverage for long-term care, consult with an accountant or attorney familiar with elder law and Medicaid to develop a plan for disposing of assets to qualify for Medicaid benefits.

Age

• Pennsylvania defines elderly as age 65 or older for Medicaid eligibility purposes. If you are under age 65, you may qualify for Medicaid due to a disability, being a guardian of a minor, or for being within another qualifying population.