Medicaid Information

What is Medicaid?

Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. Medicaid offers benefits not normally covered by Medicare, like nursing home care and personal care services. Apply through the COMPASS app or by calling the York County Assistance Office at 717-771-1100.

How Do I Qualify for Medicaid?

Generally, you must meet the Pennsylvania rules for your income and resources, and other rules (like being a resident of the state). You might be able to get Medicaid if you meet the Pennsylvania resource limit, but your income is too high to qualify. To get more details, call the Pennsylvania Medical Assistance (Medicaid) office and ask about medical help for people with limited resources.

What Does Medicaid Help Pay For?

If you have Medicare and qualify for full Medicaid coverage: Pennsylvania will pay your Medicare Part B (Medical Insurance) monthly premiums. Depending on the level of Medicaid you qualify for, the state might pay for: Your share of Medicare costs, like deductibles, coinsurance, and copayments. Part A (Hospital Insurance) premiums, if you have to pay a premium for that coverage. You'll automatically get Extra Help with your drug costs. Medicaid may pay for other drugs and services that Medicare doesn't cover. 

People who have both Medicare & Medicaid 

People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you’re dually eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have. If you're dually eligible, you’ll automatically be enrolled in a Medicare drug plan that will cover your drug costs instead of Medicaid. With drug coverage, you'll never pay 100% of the cost for drugs covered by Medicare.

 You can still pick how you want to get your Medicare coverage: Original Medicare or Medicare Advantage (Part C). Check your Medicare coverage options. If you choose to join a Medicare Advantage Plan, there are special plans for dual eligible people that make it easier for you to get the services you need, including Medicare coverage (Part D), and may also cost less, like: Special Needs Plans Medicare-Medicaid Plans (only available in certain states) Program of All-Inclusive Care for the Elderly (PACE) plans can help certain people get care outside of a nursing home.

How do I request reconsideration, if I lose my Medicaid?

Click the following link to learn how to request reinstatement of Medicare benefits within 90 days of losing them.

https://yorkcountypa.gov/DocumentCenter/View/5773/Medicaid-Request-for-Reconsideration

More information for those who are losing or have lost Medicaid

Losing Medicaid