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MEDICAL ASSISTANCE
Consumer Health Coalition at 412-456-1877 can help with filling out medical assistance forms and navigating that system. Pennsylvania Health Law Project has some very useful information on Medical Assistance in their health care guide at www.phlp.org. Call them for legal assistance at 1-800-274-3258.
PHLP also has a quickscreen tool that you can use to estimate eligibility for medical assistance:
http://www.phlp.org/quickscreen
The best way to know if you qualify for medical assistance is to apply. Some programs e.g. Charity Care programs at hospitals, require you to apply for and be turned down for medical assistance before they will consider you for their programs. To apply, call your local County Assistance Office for an application. The Allegheny County Assistance Office can be reached at 412-565-2146. For the phone number for the County Assistance Office in other counties, look in the Blue Pages of your local phone book under “State Government” and then under “Public Welfare Department”.
You can also apply online for medical assistance (as well as food stamps, cash benefits…) through the COMPASS website at:
MEDICAL ASSISTANCE FOR WORKERS WITH DISABILITIES (MAWD)
The MAWD program gives individuals with illness or disability the opportunity to go back to work without fear of losing their health benefits. You can still receive social security and be eligible for the program.
To be eligible you must:
Be between the ages of 16 and 64
Be employed at least one hour per month and receiving compensation
Be mentally, physically, or developmentally disabled (You do not have to receive SSDI)
*Disability here can be defined as having a medical condition that, if left untreated, would interfere with your ability to work.
Have countable income less that $2,394 per month as a single person (2013 limit)
Have less than $10,000 in resources
You can apply online using the COMPASS website – https://www.humanservices.state.pa.us/compass/CMHOM.aspx or over the phone at the Department of Public Welfare HelpLine at (800) 692-7462.
The Consumer Health Coalition can also help with info or with the application process. 412-456-1877 x200.
CHIP – PA CHILDREN’S HEALTH INSURANCE PROGRAM
800-986-KIDS (5437)
http://www.chipcoverspakids.com/
CHIP covers all uninsured kids and teens up to age 19 who are not eligible for Medical Assistance. No family makes too much money for CHIP because there is no income limit. Coverage is free for families that meet income requirements.
HEALTH INSURANCE FOR PENNSYLVANIA RESIDENTS
Information for consumers on insurance in PA. Terms, tips, etc. You can also file a complaint against a PA insurance provider on this site.
HIGHMARK BLUE CROSS BLUE SHIELD SPECIAL CARE
1-800-847-2004
Very basic health coverage for those who meet income requirements.
| Household Size | Income |
| 1 | Less than $21,780 |
| 2 | Less than $29,420 |
| 3 | Less than $37,060 |
| 4 | Less than $44,700 |
| 5 | Less than $52,340 |
Monthly Premium
| One Person | One Parent/ Child | One Parent/Children | Husband/Wife | Two Parents/Child | Two Parents/Children |
| $169.90 | $253.10 | $336.45 | $339.90 | $423.10 | $506.40 |
Children would be covered under CHiP if parents are eligible. Does not cover prescriptions or mental health care. 12-month pre-existing condition clause unless transferring from a different Highmark plan. No deductible.
SpecialCare covered benefits include:
- 4 doctor visits each year for preventive care, illness or injury with a copayment per visit
- Emergency care with a copayment per visit
- 21 inpatient hospital days per benefit period (90 days must elapse before the benefit period resets and another 21 days are available)
- Outpatient surgery
- Maternity care
- Newborn care (first 31 days from birth*)
- Diagnostic testing and lab work with a copayment per visit
- Preventive care including annual routine mammogram, gynecological exam and Pap test, pediatric immunizations, pediatric care and adult care
- Vision exam once every 24 months and a 50% discount on eyewear
Call for additional info.
