To apply for Medicaid in Pennsylvania, you now have three pathways. The state calls its Medicaid program Medical Assistance (MA), and you can apply online through COMPASS, in person or by mail through your County Assistance Office, or by phone through the Pennsylvania Consumer Service Center.

The pathway you choose matters less than the completeness of what you submit. The single most common cause of MA application delays is incomplete documentation: missing bank statements, missing Medicare cards, and missing resource assessments for married couples.

Key Takeaways

  • Pennsylvania has three Medicaid application pathways: (1) online via COMPASS or the myCOMPASS PA mobile app; (2) in person or by mail through the County Assistance Office (CAO) in your county of residence; (3) by phone through the Pennsylvania Consumer Service Center, where Long-Term Care and HCBS phone intake began June 16, 2025.
  • Four forms run the process. Form PA-600 (Pennsylvania Application for Benefits) is the base intake form. Form PA-600 LTC is the supplement for nursing-facility MA or HCBS waiver services. Form PA-1572 (Resource Assessment) locks the spousal snapshot for married couples. Form PA-162 (Verification Request) is what the CAO sends when documentation is missing.
  • Federal law caps the decision at 45 days, and at 90 days for people who apply for Medicaid on the basis of disability (42 CFR 435.912). That caps the agency rather than promising you a date.
  • Retroactive coverage reaches back up to 3 months before the month you apply, if you would have been eligible then and have unpaid covered bills (42 U.S.C. 1396a(a)(34)). This window shortens for applications filed on or after January 1, 2027.
  • Pennsylvania gives you 30 days to request a fair hearing, counted from the date on the written notice of the action (55 Pa. Code 275.3(b)(1)). The federal 90 days in 42 CFR 431.221(d) only caps what a state may allow, so it buys you nothing here. File in writing with your County Assistance Office, which forwards it to the Bureau of Hearings and Appeals.
  • The Pennsylvania Health Law Project (PHLP) helpline at 1-800-274-3258 provides free legal assistance with MA applications, denials, terminations, and fair hearings.

In This Guide

Pathway 1: Apply Online via COMPASS

COMPASS (Commonwealth of Pennsylvania Access to Social Services) is the state's integrated benefits portal: one account applies for Medical Assistance, food and energy assistance, children's health coverage, cash assistance, and other state-administered programs.

1
Step 1

Create a COMPASS account

Choose "Apply for Benefits" on the COMPASS landing page, then set a username, a password, an email address for status notifications, and security questions, and verify your identity. Applying on behalf of someone else, the usual long-term-care case, you indicate your relationship to the applicant (spouse, child, parent, durable power of attorney, guardian). The account is created in the applicant's name; you are the agent completing it.

2
Step 2

Choose your application type

COMPASS routes applications by benefit type. For Medical Assistance, you may select "Medical Assistance" (basic MA, cash, MAGI MA, MA for Workers with Disabilities), "Long-Term Care Medical Assistance" (institutional MA or HCBS waiver, which routes you to the LTC supplement), "Healthy Horizons" (Medicare Savings Programs: QMB, SLMB, QI-1), or "Combined Application" (several programs at once). For long-term-care and HCBS applications, choose "Long-Term Care Medical Assistance", which prompts the PA-600 LTC supplement.

3
Step 3

Complete the PA-600 application form online

COMPASS presents the PA-600 as a guided online form. The online form auto-saves, so you can return to a partial application at any time.

4
Step 4

Upload supporting documentation

COMPASS allows direct upload of documentation in PDF, JPEG, or PNG format. For long-term-care applications, uploads typically include the nursing-facility admission letter or HCBS service authorization. The full checklist appears under Pathway 2.

5
Step 5

Submit and track

COMPASS then issues an application reference number and an estimated processing date, and you can track status by logging in at any time. The assigned CAO contacts you if it needs more, typically through a PA-162 verification request.

Pathway 2: Apply In-Person or by Mail Through the County Assistance Office

Each Pennsylvania county has at least one County Assistance Office (CAO). Larger counties (Philadelphia, Allegheny, Montgomery, Bucks, Chester, Delaware, Lancaster) have several.

  • Find your CAO: use the County Assistance Office directory on the Pennsylvania Department of Human Services website
  • Operating hours: Most CAOs are open Monday through Friday, 8:00 AM to 5:00 PM. Verify with your specific CAO before visiting.
1
Step 1

Obtain Form PA-600

The PA-600 (current revision 8/24) is available three ways: download it from COMPASS as a fillable PDF, pick up free paper copies at any CAO front desk, or request a mailed copy by calling the Pennsylvania Consumer Service Center. For long-term-care applications, also obtain Form PA-600 LTC.

2
Step 2

Complete the PA-600 (and PA-600 LTC if applicable)

The paper form mirrors the COMPASS sections; complete every applicable one. Use blue or black ink and print clearly. Answer "N/A" rather than leaving items blank, because blank items prompt PA-162 verification requests. Long-term-care applicants add the PA-600 LTC supplement: facility name, Medicare/Medicaid certification number, admission date, and clinical-eligibility information. Married couples complete the PA-1572 (described below). Sign and date both forms, and if you are completing the application as an agent, attach a copy of the durable power of attorney or guardianship order.

3
Step 3

Assemble supporting documentation

The documentation burden is heavy for long-term-care applications because Pennsylvania reviews every asset transfer in the prior 60 months when you apply for long-term-care Medicaid. Work from the standard checklist below to avoid a PA-162 follow-up.

4
Step 4

Submit to the CAO

Deliver the signed application by one of the three methods described after the checklist.

The Long-Term-Care Documentation Checklist

Identity and status

  • Driver's license or state ID (or passport, military ID, or other government-issued photo ID)
  • Birth certificate (for citizenship verification)
  • Social Security card
  • Marriage certificate or divorce decree (when applicable)

Residency

  • Utility bill or lease in the applicant's name
  • For institutionalized applicants: facility admission paperwork

Citizenship and immigration

  • U.S. birth certificate or naturalization certificate, or
  • Permanent resident card and supporting immigration documentation

Income

  • Social Security benefit letter, pension and IRA distribution statements, recent pay stubs, and any veterans' benefit award letter
  • Tax forms (1099 and W-2), plus the prior-year tax return

Assets (current month, plus the 60-month look-back for long-term care)

  • Bank, brokerage, and retirement account statements for ALL accounts, 60 months back for long-term-care applications
  • Life insurance policies: declarations page plus the most recent cash-surrender-value notice
  • Vehicle titles, the deed to the primary residence and any secondary real estate, and current mortgage statements
  • Burial-contract paperwork (irrevocable contracts) and any trust documents naming the applicant as grantor or beneficiary

Medical coverage

  • Medicare card (front and back; Parts A/B/C/D), any Medicare Advantage and Part D plan cards, a Medigap declarations page, and any commercial health insurance card

For married couples (long-term care)

  • Completed Form PA-1572 (Resource Assessment), joint account statements showing snapshot-date balances, and both spouses' identity, residency, and citizenship documentation

For resource transfers (long-term care, prior 60 months)

  • Documentation of any significant gift, asset transfer, trust transfer, annuity purchase, or real estate sale

For a retroactive-coverage claim

  • Medical bills incurred 1, 2, or 3 months before the application date, with provider statements showing dates of service, charges, payments, and remaining balance

Submission Methods

There are three ways to submit the completed application to the CAO:

  • In person: drop off at any CAO and obtain a date-stamped receipt
  • By mail: send to the CAO of your county of residence; certified mail with return receipt is recommended
  • By fax: some CAOs accept faxed applications; verify the number with your CAO

The application date is the date the CAO receives a signed application, even with documentation missing. The CAO issues PA-162 verification requests for the gaps, but that date controls the retroactive-coverage window.

Pathway 3: Apply by Phone Through the Consumer Service Center

Effective June 16, 2025, the Pennsylvania Department of Human Services Consumer Service Center began accepting Long-Term Care Medical Assistance and Home- and Community-Based Services (HCBS) applications by phone, which matters most for families applying for an institutionalized parent. That expansion added two program types to a channel the state already had to offer: federal rule requires Pennsylvania to accept an application through its website, by telephone, by mail, in person, and by other commonly available electronic means, so no applicant is confined to one route.

Gather documentation before you call: a representative collects the same information the PA-600 and the PA-600 LTC ask for, so work from the long-term-care documentation checklist first.

The phone interview captures the form-based information, but supporting documentation (bank statements, the deed, life insurance policies, and the like) is submitted separately, either uploaded through COMPASS or mailed or faxed to the assigned CAO. From there, the application proceeds identically to one filed online or in person: the same federal 45-day processing cap applies (90 days for someone applying for Medicaid on the basis of disability).

How to Apply for Medicaid in Pennsylvania: Choosing a Pathway

The application date, the documentation requirements, and the federal 45-day cap on processing are the same regardless of pathway. The choice is a matter of convenience and family circumstance, not eligibility outcome.

Your situation Recommended pathway
Tech-comfortable family doing pre-application planning at home Online via COMPASS: best for unhurried, complete applications with document upload
A family member is institutionalized and you have limited time Phone via the Consumer Service Center: no in-person travel required
Complicated documentation or unusual circumstances In person at the CAO: a face-to-face interview clarifies issues
Applicant is currently in a nursing facility Phone or online: facility staff can sometimes help; in-person travel is impractical
A prior application was denied or terminated In person at the CAO plus a PHLP consultation: complex cases benefit from human dialogue
Applicant has limited English proficiency In person at the CAO with an interpreter: CAOs provide free language interpretation

The PA-600 Application Form, Section by Section

The PA-600 is organized into roughly 12 functional sections.

Section 1: Applicant information. Full legal name, all aliases, date of birth, Social Security number, marital status. Most common error: failing to list aliases (maiden names, prior married names), which delays Social Security Administration verification.

Section 2: Citizenship and immigration. Most common error: naturalized citizens who do not provide a naturalization certificate, prompting weeks of verification delay.

Section 3: Pennsylvania residency. Current address and length of residence. Most common error: institutionalized applicants giving the facility address. The residence is where the applicant lived before institutionalization if that home is preserved (and where the community spouse may still live).

Section 4: Household composition. For a married couple where one spouse is in a nursing facility, the spouses are still treated as a household for spousal-impoverishment purposes even though they no longer share a residence.

Section 5: Income. Every source for every household member: Social Security retirement and disability benefits, pension, IRA distributions, wages, rental, alimony, veterans' benefits, and more. Most common error: omitting a small pension or annuity that later surfaces in tax records.

Section 6: Assets. Every bank account, brokerage, retirement account, parcel of real estate, vehicle, life insurance policy with cash value, business interest, and trust. Most common error: not disclosing joint accounts the applicant is named on, which are typically counted as the applicant's resources unless documentation establishes otherwise.

Section 7: Health insurance. Medicare (Parts A/B/C/D), Medigap, employer, VA, and commercial coverage. Most common error: Medicare Advantage enrollees reporting only the Advantage plan and not original Medicare entitlement.

Section 8: Medical conditions and disabilities. Required for MA pathways that need a disability determination (under-65 disabled or blind applicants), not for over-65 categorically-needy applicants.

Section 9: Long-term-care information. Facility name, Medicare/Medicaid certification number, admission date, level of care, and functional-eligibility documentation. Most common error: a missing facility certification number, which the facility billing office can supply.

Section 10: Spousal information. Required for married couples even when only one spouse is applying; both spouses' finances must be reported. Most common error: a community spouse refusing to provide information, which DHS treats as if the resources are available, leading to denial.

Section 11: Resource transfers. All gifts and transfers in the prior 60 months. Most common error: failing to report family loans, gifts, or payments for in-home care by relatives without a written contract, all of which can count as uncompensated transfers for penalty-divisor purposes (see our penalty divisor and look-back guide).

Section 12: Authorizations and signature. Without a signature, the application is not filed, and the application date does not start the clock.

Married Couples: The PA-1572 Resource Assessment

For a married couple where one spouse needs long-term care, Form PA-1572 captures the snapshot of countable assets at the date of institutionalization. It lists every countable asset in either spouse's name or jointly held, documents balances at the snapshot date, and supports the Community Spouse Resource Allowance (CSRA) calculation. In 2026, the community spouse's share is one-half of the couple's countable resources, no less than $32,532 and no more than $162,660.

Request the PA-1572 as soon as the institutionalized spouse is admitted. It can be filed months before the MA application, locking the snapshot and giving the family time to spend down the applicant's portion to the resource limit. For more, see our spousal impoverishment guide.

How Long Does a Pennsylvania Medicaid Application Take?

Federal law sets a ceiling on how long a state agency may take to decide a Medicaid application. Under 42 CFR 435.912, the agency has no more than 45 days to determine eligibility for most applicants and no more than 90 days for applicants who apply for Medicaid on the basis of disability. These are the maximum periods the agency may take, measured from the application date, not a promise of speed.

Which ceiling is yours turns on the basis you applied under, not on whether a disability determination happens to arise in your case. A senior applying on the basis of age, including for nursing-facility Medical Assistance, falls under the 45-day ceiling, so a long-term-care application still open at day 60 is past its deadline rather than moving normally. The ceiling bends only in the unusual circumstances 42 CFR 435.912(e) lists, chiefly an applicant or examining physician who delays or fails to take a required action, which an unanswered PA-162 request usually is.

The most common reasons an application runs past the federal deadline:

  • Missing documentation requiring PA-162 follow-up (the most common cause)
  • Out-of-state document verification (for example, a birth certificate from another state)
  • A disability determination by SSA or Pennsylvania's Disability Determination Services
  • Spousal-impoverishment cases requiring detailed PA-1572 review
  • Penalty-divisor cases requiring look-back verification

Retroactive coverage back-stops the wait. Federal law makes coverage available for covered services furnished in or after the third month before the month you apply, if you were eligible then and have unpaid bills (42 U.S.C. 1396a(a)(34)). For long-term-care applicants, it often covers nursing-facility charges incurred before filing.

Three months is the federal default, not a guarantee: a state can shorten or drop it for some coverage groups under a Section 1115 demonstration waiver, so ask the CAO how yours applies.

One forward-looking change matters for when you apply: for applications filed on or after January 1, 2027, federal law (P.L. 119-21, section 71112) shortens the retroactive window to two months before the application month for most enrollees, and one month for the Medicaid expansion adult group.

If your application passes its federal window without resolution, request a status update from the CAO. If the office is unresponsive, escalate to PHLP at 1-800-274-3258.

After You Apply for Pennsylvania Medical Assistance

A case worker reviews the application, sends PA-162 requests for anything missing, and verifies citizenship, income, and resources with SSA and the financial institutions. Long-term-care cases then add spousal-impoverishment review (if married), penalty-divisor review (if there were transfers in the look-back), and facility verification before a determination is drafted.

The determination notice is mailed to the applicant (or the agent of record) and includes:

  • The eligibility decision (approved, denied, or partial)
  • The effective date of coverage
  • The patient-pay obligation (for institutional MA)
  • Any penalty period from uncompensated transfers
  • Fair-hearing rights and the appeal window

If approved, coverage begins on the notice's effective date and the MA card arrives within one to two weeks. Community HealthChoices enrollment, Pennsylvania's managed long-term care program where applicable, follows separately through the Independent Enrollment Broker.

For a nursing-facility resident, the patient-pay amount is the resident's income minus protected deductions, including the Personal Needs Allowance, which is $60 per month in Pennsylvania, and the Medicare Part B premium, which is $202.90 per month in 2026., Medical Assistance pays the facility the difference between that patient-pay amount and the facility's MA per-diem rate.

How to Appeal a Denial: Fair Hearings

If the CAO denies, terminates, or modifies your application in a way you believe is incorrect, you have a federal right to a fair hearing through Pennsylvania's Bureau of Hearings and Appeals (BHA).

Pennsylvania's deadline is 30 days from the date of the written notice of the action, set by 55 Pa. Code 275.3(b)(1). It stretches to 60 days where no written notice was required, and to 6 months where the required notice of the action and of your appeal rights was never sent. The 90 days in 42 CFR 431.221(d) is the ceiling on what a state may allow, not time you are given, so pacing yourself against it forfeits the appeal. If benefits are currently active, request the hearing before the action's effective date so coverage continues during the appeal.

How to file, always in writing:

  • By mail or in person to your CAO, which forwards the request to BHA
  • By uploading the signed written request through COMPASS
  • Call the CAO for the hearing form; the appeal itself must still be written

An Administrative Law Judge hears the case by telephone or in person, at your choice, and you may be represented by an attorney, a PHLP advocate, or a family member with power of attorney. Many disputes settle earlier at an informal pre-hearing conference with the CAO supervisor, worth requesting. If BHA still rules against you, you may petition the Commonwealth Court of Pennsylvania.

Thirty days is short, so call PHLP or an elder-law attorney within a week of an adverse notice.

A Note on Renewals

Medical Assistance is renewed annually. The CAO mails a recertification packet ahead of the anniversary of your determination; confirm continuing eligibility (residency, income, assets, household composition) and provide current statements. Missing the deadline causes a coverage gap even when the applicant remains eligible, so calendar the anniversary and gather documents early. For long-term-care recipients, recertification does not require redoing the PA-1572: the original resource snapshot remains controlling for the Community Spouse Resource Allowance unless the community spouse's circumstances change materially.

Frequently Asked Questions

What is the fastest way to apply for Medicaid in Pennsylvania?

For most families, the phone pathway through the Consumer Service Center is the fastest. The phone interview routes the application to your county CAO, and you submit supporting documentation through COMPASS or by mail afterward. The newer phone channel opened for Long-Term Care and HCBS applications on June 16, 2025.

How long does it take to get approved for Medicaid in Pennsylvania?

Federal law caps the decision at 45 days for most applicants and at 90 days for people who apply for Medicaid on the basis of disability (42 CFR 435.912). That is a limit on the agency, not a promised date, and it turns on the basis you applied under, so a senior applying on the basis of age is under the 45-day cap even for a nursing-facility application. Missing documentation and PA-162 verification cycles are the most common reasons a long-term-care application runs past the deadline.

Can I get retroactive Medical Assistance coverage in Pennsylvania?

Yes. Federal law allows up to three months of retroactive coverage before the application month, as long as you were eligible during those months and have unpaid covered bills (42 U.S.C. 1396a(a)(34)). For applications filed on or after January 1, 2027, the window shortens to two months for most enrollees and one month for the Medicaid expansion adult group.

What forms do I need to apply for Medicaid in Pennsylvania?

The base form is the PA-600 Pennsylvania Application for Benefits. Long-term-care applicants also complete the PA-600 LTC supplement. Married couples seeking spousal-impoverishment protection complete the PA-1572 Resource Assessment. The CAO sends a PA-162 Verification Request when it needs more documentation.

How do I appeal a Medical Assistance denial?

Request a fair hearing in writing within 30 days of the date on the written notice, the deadline Pennsylvania sets at 55 Pa. Code 275.3(b)(1). The 90 days in 42 CFR 431.221(d) caps what a state may allow and gives you nothing extra here. File the written request with the County Assistance Office that took the action, and it forwards the appeal to the Bureau of Hearings and Appeals. The Pennsylvania Health Law Project at 1-800-274-3258 provides free legal assistance.

Where to Get Help

Pennsylvania Health Law Project (PHLP) Free legal help with applications, denials, terminations, and fair hearings. 1-800-274-3258 phlp.org
County Assistance Office (CAO) Files and decides your Medical Assistance application in your county of residence. pa.gov/agencies/dhs
Independent Enrollment Broker Community HealthChoices and HCBS waiver enrollment after MA approval. 1-877-550-4227
APPRISE Pennsylvania's State Health Insurance Assistance Program, free Medicare counseling. 1-800-783-7067

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidPennsylvania Medicaid Programs OverviewPennsylvania Medical Assistance for seniors: 2026 income and two-tier asset limits, a daily penalty divisor, probate-only estate recovery, and how to apply. MedicaidPA Medicaid Eligibility and Income LimitsPennsylvania Medicaid income limits for 2026: the $2,982 long-term-care income cap, the two-tier $2,400/$8,000 asset limit, and how seniors qualify. MedicaidPennsylvania Community HealthChoicesHow Community HealthChoices works in Pennsylvania in 2026: the three CHC plans, who must enroll, the carve-outs, Services My Way, and how to choose a plan. MedicaidPennsylvania Medically Needy Spend-DownHow Medicaid Pennsylvania medically needy spend-down works in 2026: the MNIL, six-month cycle, eligible bills, and the Miller Trust comparison. MedicaidPA Medical Assistance Estate RecoveryHow Pennsylvania Medicaid estate recovery works in 2026: probate-only scope, the $2,400 small-estate waiver, postponement rules, and hardship waivers. MedicaidPA Spousal Impoverishment ProtectionsMedicaid Pennsylvania spousal impoverishment in 2026: CSRA $162,660 cap, MMNA $4,066.50 max, PA-1572 snapshot, and PA's income-first methodology.

Find personalized help applying for Medical Assistance in Pennsylvania at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.