Pennsylvania Medicaid and CHIP income limits, 2026
Pennsylvania expanded Medicaid, so Medical Assistance covers adults 19 to 64 with income up to $1,836 a month for 1 person (138% of poverty). Children are covered up to $8,773 a month for a family of 4 (319%), and pregnant people up to $3,968 for a household of 2 (220%).
- Medicaid expansion
- Yes
- Work requirement
- By January 1, 2027
- Last verified
Pennsylvania limits by group, as a percent of poverty
| Group | Limit |
|---|---|
| Adults 19-64 (Medicaid expansion) | 138% |
| Parents and caretaker relatives | 33% |
| Pregnant | 220% |
| Children under 19, highest limit (Medicaid or CHIP) | 319% |
Percents include the 5% income disregard that Medicaid applies to modified adjusted gross income (MAGI), so the federal 133% standard shows as 138%. Older adults (65+) and people with disabilities have separate, non-MAGI rules not shown here.
Limits for children by age band (under 1, 1-5, 6-18) are being verified; the table shows the highest limit any child can qualify under.
Pennsylvania monthly income limits by household size
| Household size | Adults 19-64 (138%) | Parents and caretaker relatives (33%) | Pregnant (220%) | Children under 19 (319%) |
|---|---|---|---|---|
| 1 person | $1,836 | $439 | $2,926 | $4,243 |
| 2 people | $2,489 | $596 | $3,968 | $5,753 |
| 3 people | $3,142 | $752 | $5,009 | $7,263 |
| 4 people | $3,795 | $908 | $6,050 | $8,773 |
| 5 people | $4,449 | $1,064 | $7,092 | $10,283 |
| 6 people | $5,102 | $1,220 | $8,133 | $11,793 |
| 7 people | $5,755 | $1,377 | $9,174 | $13,303 |
| 8 people | $6,408 | $1,533 | $10,216 | $14,813 |
Percent x the 2026 HHS poverty guideline for the 48 contiguous states and DC / 12, rounded up. Pennsylvania's own chart may differ by a dollar; the state's chart decides. A pregnant woman counts each expected baby in the household size.
Medicaid work requirement in Pennsylvania
No later than January 1, 2027 for adults in the Medicaid expansion group, under federal law.
Exemptions in the federal law include parents and caretakers of a child 13 or younger or of a person with a disability, people who are pregnant or postpartum, people who are medically frail, veterans with a total disability rating, and people meeting TANF or SNAP work rules. Pennsylvania's Medicaid agency will say what you need to report.
Pennsylvania notes
- Pennsylvania's Medicaid program is Medical Assistance. Its CHIP is free to 208% of poverty, with subsidized tiers to 314% and full-cost coverage above that.
- Pennsylvania's CHIP income limits took effect March 1, 2026.
Other 2025 federal law changes
Public Law 119-21 did not change the income limits above. It changes who stays covered and how:
- Fewer non-citizens qualify for federally funded coverage. Federal Medicaid and CHIP funding is limited to citizens, lawful permanent residents, Cuban and Haitian entrants and citizens of the Compact of Free Association nations. Other lawfully present immigrants, such as refugees and people granted asylum, lose federally funded coverage unless the state pays. From October 1, 2026.
- Renewals every 6 months for expansion adults. Expansion adults must have their eligibility re-checked every 6 months instead of every year. Renewals from January 1, 2027.
- Shorter retroactive coverage. Medicaid can pay medical bills from before you applied for only 1 month (expansion adults) or 2 months (everyone else), instead of 3. Applications from January 1, 2027.
- Cost sharing for expansion adults above the poverty line. Expansion adults with income above 100% of poverty can be charged up to $35 per service, capped at 5% of family income. From October 1, 2028.
How to apply in Pennsylvania
- Online: COMPASS
- Pennsylvania Department of Human Services: Medical Assistance eligibility
- Phone: 1-866-550-4355
- You can apply any time of year. If your income is too high for Medical Assistance, the same application can check you for a subsidized plan on HealthCare.gov or your state's marketplace. Only the Pennsylvania Department of Human Services can decide eligibility.
Sources
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels
- https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/services/assistance/documents/aca/2026-presumptive-eligibility-income-limits.pdf
- https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/chip/eligibility-and-benefits/documents/chip-fpig.pdf
- HHS 2026 poverty guidelines
- Public Law 119-21 (2025)
Pennsylvania's chart and Medicaid.gov were compared field by field on ; page updated . We re-check every state each spring, after states adopt the new poverty guidelines. See how we verify benefits limits.