Wondering about the Pennsylvania Medicaid income limits this year? Here’s the simple 2025 chart for every situation — kids, adults, pregnant women, seniors, and long-term care — so you instantly know if you qualify. We’re covering every single Medicaid income limit in Pennsylvania, how to apply, what counts as income, how to fix being “a little over the limit,” and even the scary nursing home stuff. Let’s go!
The One Thing Everyone Gets Wrong
There is NO single monthly income limit for Medicaid in PA.
It changes depending on who’s applying. Here are the real groups:
1. Adults 19–64 Without Medicare (Medicaid Expansion)
- You can make up to $1,800/month (single)
- $2,433 (2 people)
- $3,065 (3 people)
- $3,698 (4 people)
- Add about $630 for each extra person
→ No savings check at all! This is the famous 138% of federal poverty level rule.
2. Kids Under 19 (and CHIP if you’re just a tiny bit over)
- Babies under 1 year: up to $3,978/month for a single mom + baby (317% FPL)
- Ages 1–5: up to about $3,718 (family of 2)
- Ages 6–18: same as adults 19–64
- If you’re just over, Pennsylvania CHIP kicks in automatically — still free or super cheap.
3. Pregnant Women & New Moms
- You get 12 full months after the baby is born with the super-high baby limits
- Example: mom + baby = up to $5,398/month and still fully covered (317% FPL)
4. People 65+, Blind, or Disabled (SSI-Related / Aged Blind Disabled Medicaid)
- Only $989/month (single) or $1,483 (couple)
- They DO check your savings — only $2,000 allowed (single)
5. Need Nursing Home or In-Home Help (Long-Term Care / HCBS Waivers / Community HealthChoices)
- You can actually make up to $2,901/month — you just pay the nursing home the extra (after keeping a tiny allowance)
- Savings limit: still $2,000 for the person who needs care
- Your house, car, and prepaid funeral are safe
6. Disabled & Still Working? (MAWD – Medical Assistance for Workers with Disabilities)
- One of the highest limits: $3,261 single or $4,407 couple
- You can have $10,000 in the bank
7. On Medicare and Need Help Paying Premiums? (Medicare Savings Programs)
- QMB (best one): up to $1,304/month single — pays ALL Medicare costs
- SLMB & QI-1: a little higher income, still helps a ton
8. A Little Over the Limit? → Medically Needy / Spend-Down Program
- You only have to get down to $425/month (single) by paying medical bills
- Works like a deductible — super common way people still qualify
What Actually Counts as Income in Pennsylvania?
YES → they count it:
- Regular paychecks
- Social Security Disability (SSDI)
- Social Security retirement
- Pensions
- Rental income
- Cash gifts from family
- Unemployment
- Interest from savings
NO → they usually ignore it:
- SSI payments
- Food stamps (SNAP)
- Child support you receive
- Housing help
- Most student loans/grants
- The value of your house and one car
Can You Own a House and Still Get Medicaid in PA?
YES! Your primary home is almost always safe (up to $730,000 equity for long-term care).
The 5-Year Look-Back Rule Explained Like You’re 15
If someone needs nursing home or in-home care, Pennsylvania looks back 5 whole years.
If you gave away money or sold something too cheap, they make you wait before Medicaid pays.
Current penalty: about $475 per day you have to private-pay.
Spousal Protections (So the Healthy Husband/Wife Doesn’t Go Broke)
- The at-home spouse can keep up to $157,920 in savings
- Can keep the house, car, everything normal
- Gets a monthly income allowance up to $3,853
How to Legally “Spend Down” and Still Qualify
- Pay off credit cards
- Fix the roof or buy a new furnace
- Buy a newer, safer car
- Pre-pay your funeral
- Put extra income in a Miller Trust or Pooled Special Needs Trust
How to Apply for Pennsylvania Medicaid (Takes 10 Minutes)
- Go to mycompass.pa.gov
- Make a free account
- Click “Apply for Benefits”
- Pick Medical Assistance
- Answer the easy questions
- Snap pics of pay stubs/ID with your phone
- Submit → kids & pregnant moms often approved in days!
Most Common Reasons People Get Denied (and the Fix)
- Forgot to send proof → just upload it
- Think they make too much → apply anyway, spend-down exists
- Gave money away in last 5 years → talk to an elder law attorney ASAP
- Didn’t report a tiny bank account → always tell the truth
You can appeal in 30 days — most appeals win!
Emergency Medicaid & Undocumented Families
- Hospital emergencies (including giving birth) are covered even if parents aren’t citizens
- U.S.-born kids qualify no matter what
Pennsylvania Medicaid vs Medicare (Quick Chart)
| Pennsylvania Medicaid | Medicare | |
| Pays nursing homes | Yes | No |
| Pays in-home caregivers | Yes | Almost never |
| Has income/asset limits | Yes (depends on group) | No |
| Premiums | Usually $0 | Part B costs money |
Quick FAQ – Pennsylvania Medicaid income limits
- Does Social Security count toward Medicaid income in PA? → Yes for kids/adults, usually no for seniors getting SSI
- What if I’m $100 over the income limit? → Spend-down or MAWD can save you
- Can I have Medicaid and Medicare at the same time? → Yes! Called dual eligible
- How long does it take to get approved? → 7–45 days
- What’s the difference between Medicaid and CHIP in PA? → CHIP is for kids just over the Medicaid limit — still free or tiny co-pay
Your Next Step (Takes 5 Minutes)
Go to mycompass.pa.gov right now and run the free screener.
It tells you exactly what you qualify for — no pressure, no cost, no judgment. Please remain get in touch for more SNAP Benefits Updates
