Medical Assistance for Older People
and People with Disabilities
Pennsylvania's Medical Assistance (Medicaid) program provides health care benefits for older people (ages 65 and older), people with disabilities, or people who are blind. Information on this page describes general eligibility requirements and benefits.
Non-Money Payment (NMP)
|
Number of People |
NMP Categories Net Monthly Income Limit |
1
| $965.10
|
2
| $1,448.30
|
Medically Needy Only (MNO)
| Number of People |
MNO Categories Net Monthly
Income Limits |
MNO Categories Net 6-Month
Income Limits |
| 1 | $ 425 | $ 2,550 |
| 2 | $ 442 | $ 2,650 |
| 3 | $ 467 | $ 2,800 |
| 4 | $ 567 | $ 3,400 |
| 5 | $ 675 | $ 4,050 |
| 6 | $ 758 | $ 4,550 |
| 7 | $ 850 | $ 5,100 |
| 8 | $ 942 | $ 5,600 |
| Each Additional Person | $ 92 | $ 550 |
State Blind Pension
State-funded program dedicated to helping low-income individuals and families who meet visual and other eligibility requirements move to independence. View additional information on the State Blind Pension program.
Healthy Horizons
Eligible persons may be eligible to receive help to pay their Medicare premiums. The Medical Assistance program (also referred to as Medicaid) includes a coverage plan designed to help elderly individuals or individuals with disabilities who are eligible for Medicare to pay some or all of their Medicare premiums. Individuals must meet income and resource limits. Income limits are based on a percentage of the Federal Poverty Income Guidelines (FPIG), which are revised annually. Healthy Horizons includes the following:
Qualified Medicare Beneficiary (QMB) — Categorically Needy Program
Also known as Healthy Horizons in Pennsylvania, individuals who qualify for these benefits are eligible for Medical Assistance payments of their Medicare Part A and Part B premiums and payment of Medicare deductibles and coinsurance. They are also eligible for medical coverage through the Medical Assistance program. Income and resource limits are as follows:
|
Number of People |
2024 Federal
Poverty Level (FPIG) |
Monthly Income Limit
(FPIG + $20 Deductible = Limit |
Resource Limit |
| 1 | 100 percent or less | $1,255 + $20 = $1,275
| $2,000 |
| 2 | 100 percent or less | $1,704 + $20 = $1,724
| $3,000 |
Qualified Medicare Beneficiary (QMB) — Medicare Cost-Sharing Program
Also known as Healthy Horizons-Medicare Cost-Sharing in Pennsylvania, individuals who qualify for these benefits are eligible for payment of their Medicare Part A and Part B premiums and payment of Medicare deductibles and coinsurance. Income and resource limits are as follows:
|
Number of Persons |
2024 Federal Poverty Level (FPIG) |
Monthly Income Limit
(FPIG + $20 Deductible = Limit)
|
Resource Limit |
| 1 | 100 percent or less | $1,255 + $20 = $1,275
| $9,430
|
| 2 | 100 percent or less | $1,704 + $20 = $1,724
| $14,130
|
Specified Low-Income Medicare Beneficiary (SLMB) Program
Individuals who qualify for these benefits are eligible for payment of their Medicare Part B premium only. Income and resource limits are as follows:
Number of People
|
2024 Federal
Poverty Level (FPIG) |
Monthly Income Limit
(FPIG + $20 Deductible = Limit) |
Resource Limit |
1
| At least 100 percent but less than 120 percent
| $1,255 + $20 = $1,275
Less than $1,506 + $20 = $1,526
| $9,430
|
2
| At least 100 percent but less than 120 percent
| $1,704 + $20 = $1,724
Less than $2,044 + $20 = $2,064
| $14,130
|
Qualifying Individuals Group 1 (QI-1)
Individuals who qualify for these benefits are eligible for payment of their Medicare Part B premium only. Income and resource limits are as follows:
|
Number of People |
2024 Federal
Poverty Level (FPIG) |
Monthly Income
Limit (FPIG + $20 Deductible) |
Resource Limit |
| 1 | At least 120 percent but
less than 135 percent
| $ 1,506 + $20 = $1,526
Less than $ 1,695 + $20 = $1,715
| $9,430
|
| 2 | At least 120 percent but
less than 135 percent
| $2,044 + $20 = $2,064
Less than $2,300 + $20 = $2,320
| $14,130
|