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​Medical Assistance for Older People
and People with Disabilities

Pennsylvania's Medical Assistance (Medicaid) program provides health care benefits for older people and people with disabilities. Information on this page describes general eligibility requirements and benefits.

Categorically Needy

    • SSI recipients
    • SSI-related (age 65 or older, disabled and blind) persons
Number of People NMP Categories Net Monthly Income Limit
1$805.10
2 $1,208.30

Medically Needy Only

    • SSI-related (aged, disabled and blind)
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 2020 Federal
Poverty Level (FPIG)
Monthly Income Limit
(FPIG + $20 Deductible = Limit
Resource Limit
1100 percent or less$1,064 + $20 = $1,084
$2,000
2100 percent or less$1,437 + $20 = $1,457
$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 2019 Federal Poverty Level (FPIG) Monthly Income Limit
(FPIG + $20 Deductible = Limit)
Resource Limit
1100 percent or less$1,064 + $20 = $1,084
$7,860
2100 percent or less$1,437 + $20 = $1,457
$11,800

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 Persons 2019 Federal
Poverty Level (FPIG)
Monthly Income Limit
(FPIG + $20 Deductible = Limit)
Resource Limit
1At least 100 percent but less than 120 percent
$1,064+ $20 = $1,061
Less than $1,276 + $20 = $1,296
$7,860
2At least 100 percent but less than 120 percent
$1,437 + $20 = $1,457
Less than $1,724 + $20 = $1,744
$11,800

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 2019 Federal
Poverty Level (FPIG)
Monthly Income
Limit (FPIG + $20 Deductible)
Resource Limit
1At least 120 percent but
less than 135 percent
$ 1,276 + $20 = $1,296
Less than $ 1,436 + $20 = $1,456
$7,860
2At least 120 percent but
less than 135 percent
$1,724 + $20 = $1,744
Less than $1,940 + $20 = $1,960
$11,800