Pennsylvania Medicaid
Pennsylvania Medical Assistance
Apply or call
Pennsylvania Medical Assistance covers pregnant women up to 215% of the federal poverty line — roughly $55,510 annual income for a family of three in 2025. The state adopted Medicaid expansion in 2015. Apply at https://www.compass.state.pa.us/ or call 1-866-550-4355.
On maternal health specifically: Pennsylvania Medical Assistance has extended postpartum Medicaid coverage to 12 months (effective 2023-04-01), and has a doula Medicaid benefit pending CMS approval.
Governor Tom Wolf rolled back Corbett-era Healthy PA work requirements in his first year (2015), fully implementing expansion. Act 117 of 2023 directed the Department of Human Services to pursue a Section 1915(i) State Plan Amendment to add doula services — implementation was expected in 2025.
Key facts at a glance
- Pregnant women eligible up to 215% FPL ($55,510 for a family of three in 2025).
- Children 0-5 eligible up to 215% FPL ($55,510 for a family of three).
- Expansion adults eligible up to 138% FPL ($35,630 for a family of three).
- Postpartum Medicaid extended to 12 months (effective 2023-04-01).
Pennsylvania Medicaid, topic by topic
Eligibility
Income limits & who qualifies
Pennsylvania Medical Assistance covers pregnant women up to 215% of the federal poverty line — $55,510 annual income for a family of three …
How to apply
How to apply step by step
Apply online at https://www.compass.state.pa.us/ or by phone at 1-866-550-4355. Federal law requires a 45-day decision on non-disability ap…
Doula coverage
Doula coverage details
Pennsylvania Medical Assistance has a Medicaid doula benefit pending CMS approval.
Postpartum extension
12-month postpartum status
Pennsylvania Medical Assistance extended postpartum Medicaid coverage to 12 months, effective 2023-04-01.
Pregnant women
Pregnancy coverage in full
Pennsylvania Medical Assistance covers pregnancy-related care up to 215% of the federal poverty line — about $55,510 annual income for a fa…
Renewal
Annual renewal & unwinding
Pennsylvania Medical Assistance redetermines eligibility at least once every 12 months under 42 CFR 435.916. During the 2023+ unwinding, ro…
For Black families
Roughly 505,000 Black residents are enrolled in Pennsylvania Medical Assistance, per the most recent CMS T-MSIS analytic file. The number understates true eligibility: every state has Black eligibles who aren't currently enrolled, usually because of the administrative-churn rates that rose sharply during the 2023 unwinding.
Governor Tom Wolf rolled back Corbett-era Healthy PA work requirements in his first year (2015), fully implementing expansion. Act 117 of 2023 directed the Department of Human Services to pursue a Section 1915(i) State Plan Amendment to add doula services — implementation was expected in 2025.
For enrollment help: look for your state's Navigator program (federally funded under the ACA), a Federally Qualified Health Center in your county (every FQHC has certified application counselors on staff), or one of the named community organizations below. Our FQHC directory filters to this state at /clinics/pa/.
More on Pennsylvania from Black Health
FQHCs
Federally Qualified Health Centers in Pennsylvania
Sliding-scale clinics that take Medicaid + help with applications.
Providers
Providers who accept Medicaid in Pennsylvania
Filter our directory to Pennsylvania by specialty.
Health data
Black Health outcomes in Pennsylvania
Maternal mortality, life expectancy, uninsured rate by race.
Data sources
- Pennsylvania Medical Assistance — state Medicaid portal.
- KFF State Health Facts, Medicaid income eligibility + expansion + enrollment tables (kff.org/statedata).
- National Health Law Program doula Medicaid project (healthlaw.org/doulamedicaidproject).
- March of Dimes Report Card, 12-month postpartum extension tracker (marchofdimes.org/report-card).
- CMS T-MSIS Analytic Files, Medicaid enrollment by race and ethnicity (medicaid.gov/dq-atlas).
- HHS Poverty Guidelines, 2025 Federal Register release.
Data refreshed: