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October 6

Changes are coming to Medicaid!

Starting January 1, 2027, some Medicaid recipients in Pennsylvania will need to meet work requirements and will need to have their Medicaid eligibility checked every six months instead of every year. Medicaid is also called Medical Assistance or MA in Pennsylvania.

Who is affected by the new Medicaid rules?

Medicaid recipients will need to meet these new requirements if they:

  • Are 19-64 years old
  • Do not have a dependent/child under 14 years old

How do you meet Medicaid work requirements?

A Medicaid recipient can meet work requirements if they do one or a combination of these activities for at least 80 hours a month:

  • Work;
  • Volunteer or do community service;
  • Participate in a job training program; and/or
  • Go to school at least half-time

Medicaid recipients may also meet the requirement based on their monthly income if they make at least $580 each month. They may also meet the requirement depending on their income if they do seasonal work, and a caseworker can help calculate if their income meets this option.

Is anyone exempt from Medicaid work requirements?

Some people do not have to meet work requirements to get or keep Medicaid. People who have certain health needs or a disability, are pregnant or recently gave birth, take care of a child or disabled family member, or meet other conditions that exempt them from these requirements.

How do I show I am meeting Medicaid work requirements?

The Pennsylvania Department of Human Services’ (PA DHS’) goal is to help Pennsylvanians understand these changes and meet the new requirements. Current Medicaid recipients affected by these changes will receive a letter in the mail(opens in a new tab) from PA DHS soon that will include information on whether they need to meet these requirements or provide more information to PA DHS about their income or work, volunteer, school, or training activities.

If you or someone you know are affected by the new Medicaid rules, the work requirements will start at your first renewal in 2027. People applying for Medicaid coverage will have to show that they meet work requirements during their application.  

LCH may be able to help patients manage these changes; please visit LCH’s Social Assistance to learn more.

For more information on these changes, visit dhs.pa.gov/MedicaidChanges or call LCH at 610-444-7550 to speak to our Social Assistance Team.

LCH Health & Community Services