Pennsylvania · Medicaid
Medicaid in Pennsylvania
Looking for Medicaid eligibility in Pennsylvania? Here is how this coverage lane works specifically for Pennsylvania residents, what it costs, and how to get it.
Facts on this page checked Jan 15, 2026. Sources are listed at the end.
How it works here
Medicaid, explained for Pennsylvania.
Pennsylvania expanded Medicaid under the ACA, so adults with income up to 138% of the Federal Poverty Level may qualify regardless of whether they have children.
Medicaid in Pennsylvania provides free or very low-cost comprehensive coverage for those who qualify, and you can apply year-round — there is no enrollment window.
If you do not qualify for Medicaid in Pennsylvania, a subsidized Marketplace plan through Pennie is usually the next best option.
Pennsylvania's Medical Assistance program covers expansion adults and traditional categories after the state adopted ACA expansion.
Income-eligible adults can enroll year-round; those who exceed Medicaid limits are routed to Pennie for premium tax credit estimates.
County assistance offices and Pennie both play roles in applications — starting at pennie.com is usually the simplest path for a household coverage check.
Pennsylvania facts
- Marketplace
- Pennie
- Medicaid expansion
- Adopted
- Uninsured rate
- ~5.5%
Open enrollment 2027
When Pennsylvania can enroll.
- Most exchanges open
- Nov 1, 2026
- Most exchanges close
- Jan 15, 2027
- Pennie dates
- Set by the state
- Confirm before you rely on a date
Pennsylvania runs its own exchange. We do not have a state-specific date on file. Confirm with Pennie before you rely on a date. Outside this window, a qualifying life event (a move, a new baby, losing other coverage) can open a Special Enrollment Period.
Medicare is different.Medicare’s annual enrollment runs Oct 15 to Dec 7, 2026. For Medicare help, visit our sister site OLYRON Medicare or Medicare.gov.
Dates checked Oct 15, 2026. Sources: HealthCare.gov: dates and deadlines; CMS statement, Jul 27, 2026.
More in this state
Other coverage in Pennsylvania.
- ACA Marketplace plansSubsidy-eligible major-medical plans sold on the exchange.
- Health sharingMember-funded medical cost sharing — not insurance.
- Short-term plansTemporary coverage to bridge a gap — limited benefits.
- MedicareOriginal Medicare, Advantage, and Medigap for 65+ and eligible.
- DentalStandalone and bundled dental coverage options.
- VisionEye exams, glasses, and contacts coverage.
- TelehealthVirtual primary and urgent care memberships.
Questions
Good questions, short answers.
Who qualifies for Medicaid in Pennsylvania?
Adults with income up to about 138% of the Federal Poverty Level, plus children, pregnant women, and others who meet income rules.
Can I apply for Medicaid any time in Pennsylvania?
Yes — unlike Marketplace plans, Medicaid enrollment is open year-round for those who qualify.
Did Pennsylvania expand Medicaid?
Yes. Pennsylvania adopted ACA Medicaid expansion, which generally opens coverage to more low-income adults.
Sources
- Medicaid.gov — federal Medicaid program information · reviewed 2026-01-15
- KFF (Kaiser Family Foundation) — health policy research · reviewed 2026-01-15
- OLYRON HealthMatch editorial methodology — how we source and rate options · reviewed 2026-01-15
Before the rush
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