Pennsylvania Medicaid Eligibility Calculator (2026)

CHIP picks up early

Medical Assistance covers babies to 215% of the poverty line, children 1–5 to 157% and older children to 133%; Pennsylvania’s CHIP covers children above those points up to 314% (319% with the disregard).^[MACPAC] Pregnancy coverage runs to 215%.^[MACPAC]

Expansion since 2015

Pennsylvania implemented the expansion on January 1, 2015, a year after the first wave.^[KFF] Its parent/caretaker group alone stops at 33% of the poverty line.^[MACPAC]

Postpartum

Pennsylvania’s postpartum extension to a year was approved October 27, 2022.^[KFF] Newborns of Medical Assistance mothers are deemed eligible to 215% of the poverty line.^[MACPAC]

The jump between ages matters in Pennsylvania: a baby is in Medical Assistance to 215% of the poverty line, but a 2-year-old’s Medicaid stops at 157% and a 7-year-old’s at 133%, so siblings often end up split between Medical Assistance and CHIP. For nursing-home or waiver care the income cap is three times SSI, $2,982 a month.^{[MACPAC][MACPAC]}

Applying

COMPASS handles Medical Assistance and CHIP applications for the Department of Human Services. Older Pennsylvanians have a 100% poverty-level pathway and a medically needy spend-down near 33%.^[MACPAC]