Medicaid income limits PA: Medical Assistance and CHIP in 2026

What is the monthly income limit for Medicaid in PA?

For most adults aged 19 to 64, the monthly income limit for Medicaid in PA is $1,836 for one person, $2,489 for two, $3,142 for three and $3,795 for four in 2026.^[1][2] The Department of Human Services (DHS) defines the adult group as incomes “at or below 133 percent” of the poverty guidelines and then publishes a separate 138% table that already contains the 5% disregard: $22,025 a year for one person and $45,540 for four, effective January 13, 2026.^[2][1] The table below converts every Pennsylvania group to monthly dollars with the 2026 HHS guidelines.^[8]

Read across to your household size. A row marked “incl. 5% disregard” already has the extra five points built in; the CHIP row is the top of low-cost CHIP, not a hard ceiling, because families above it can still buy full-cost coverage.^[3]

Adults and parents in Pennsylvania’s expansion group

Pennsylvania has expanded Medicaid, so adults 19 to 64 qualify for Medical Assistance with income at or below 133% of poverty (138% after the disregard), whether or not they have children.^[2] That makes the expansion line the one that matters for almost every working-age applicant.

An older parent and caretaker standard still exists on paper. Medicaid.gov lists it at 33% of poverty (data as of December 2023), and DHS’s 2026 tables carry a matching 33% column of $439 a month for one person and $752 for three.^[7][1] With the 5% disregard the checker shows $866 for a family of three. A mother or father earning more than that, but no more than $3,142 in a family of three, simply qualifies as an expansion adult instead.

Pregnancy, children and Pennsylvania’s CHIP tiers

Pregnant women and babies under 1 qualify for Medical Assistance up to 215% of poverty, which DHS prints as $2,860 a month for one person, with a separate 5% disregard column worth another $66.50.^[1] Children aged 1 to 5 qualify up to 157% and children 6 to 18 up to 133%, each plus the disregard (162% and 138%).^[1] For a family of four that works out to $6,050 for an infant, $4,455 for a preschooler and $3,795 for a school-age child.

Above those lines, CHIP takes over with three price levels, using annual income:^[3]

• Free CHIP: no premium, up to 208% of poverty.^[3]
• Low-cost CHIP: from 208% to 314%, with average monthly premiums of $65, $91 or $104 per child depending on the income band.^[3]
• Full-cost CHIP: above 314%, where the chart lists “No Limit” on income.^[3]

The CHIP chart switched to the 2026 guidelines on March 1, 2026, later than the January 13 Medical Assistance tables, and it notes that a family below any amount listed could be eligible for Medical Assistance instead.^[3][1]

Seniors and people with disabilities: Healthy Horizons and asset limits

People who are 65 or older, blind or disabled face lower income limits and an asset test in Pennsylvania. The Healthy Horizons categorically needy limit is 100% of poverty plus a $20 disregard, or $1,350 a month for one person and $1,824 for a couple, with resources capped at $2,000 and $3,000.^[4] Two other DHS standards apply to people who do not meet it:

• SSI-related Non-Money Payment: net monthly income up to $1,016.10 for one person or $1,524.30 for two.^[4]
• Medically Needy Only: a net monthly income level of $425 for one person.^[4]

The table header on that DHS page still reads “2025 Federal Poverty Level”, but the dollar amounts already match the 2026 guidelines.^[4][8]

How Pennsylvania counts income for Medical Assistance

Medical Assistance for children, pregnant women, parents and expansion adults uses Modified Adjusted Gross Income (MAGI), and MAGI rules “generally include” a disregard equal to 5% of the poverty line.^[7] Pennsylvania shows both versions: the adult table at 138% and, for pregnancy and young children, the base percentage with the $66.50 disregard listed beside it.^[1] The poverty line itself is $15,960 a year for one person in 2026, plus $5,680 for each additional person.^[8] Two practical points follow:

• The pregnancy and child columns in the DHS tables are printed before the disregard ($2,860 for one person at 215%), so the checker’s figures run slightly higher than that column.^[1]
• CHIP is tested on annual income, while the Medical Assistance tables are monthly; use the matching column when you compare.^[3][1]
• Applicants who are 65 or older, blind or disabled are not on MAGI: their limits add a flat $20 disregard instead, and an asset test applies.^[4]

How to apply through COMPASS

You apply for Medical Assistance and CHIP online through COMPASS, Pennsylvania’s benefits website, or by calling the Consumer Service Center for Health Care Coverage at 1-866-550-4355.^[6] CHIP questions go to 1-800-986-KIDS.^[3] For the 2027 federal changes DHS runs a separate HR1 FAQ line at 1-877-883-6383.^[5]

• COMPASS (apply, renew, report changes) Pennsylvania DHS
• CHIP income guidelines chart (PDF) effective March 1, 2026
• Changes Coming to Medicaid in Pennsylvania HR1 FAQ line 1-877-883-6383

What changes for Pennsylvania Medicaid in 2027

From January 1, 2027, adults 19 to 64 on Medical Assistance who do not have a dependent child under 14 must meet a work requirement or an exemption and report it to DHS when they apply or renew.^[5] Federal rules set the bar at 80 hours a month of work, community service, school or a work program, or income of at least $580 a month.^[9] Coverage does not switch off on January 1: current members report at their next renewal date in 2027.^[5]

• Six-month renewals. Some adults 19 to 64 will renew every six months instead of every year; current members switch after their next renewal in or after February 2027.^[5][10]
• Shorter retroactive coverage. For new applicants from January 1, 2027, back-coverage for old medical bills drops from three months to one month for expansion adults and two months for everyone else.^[5]
• Immigrant eligibility. Since October 1, 2026, federal Medicaid money covers only citizens, green-card holders, Cuban and Haitian entrants and COFA migrants, with limited exceptions.^[11]

Food help uses a different income test: see Pennsylvania food stamps for SNAP, or the national food stamps income limit tables. To compare Medicaid rules, try Virginia Medicaid income limits, Idaho Medicaid income limits and North Carolina Medicaid income limits, or go back to the SNAP calculator.