Medical Assistance (MA) benefits are available to an individual who is a resident of Pennsylvania, assuming all other eligibility requirements are met. There is no requirement as to the length of time someone must live in the state if he or she is applying for MA. 55 Pa. Code § 148.1
NOTE: Persons who have applied for MA but get MA in another state, in any category including SSI, are eligible for MA in Pennsylvania in the month in which they apply, as long as the individual meets the definition of a resident.
Pennsylvania does not provide MA to cover services received in Pennsylvania by residents of other states. In these situations, it is the responsibility of the other state to provide MA coverage. 42 CFR § 431.52
An individual of any age who receives an SSI State Supplement is considered a resident of the state making the supplemental payment. 55 Pa. Code § 148.18
An individual stays a resident of Pennsylvania when he or she leaves the state temporarily, as long as: 55 Pa. Code § 148.13
The individual plans to return to Pennsylvania when the purpose for leaving is completed.
No other state has decided that the individual is a resident there for MA purposes.
A resident who receives inpatient hospital care in another county or state is considered a resident of the Pennsylvania county where the individual keeps a permanent home. 55 Pa. Code § 148.11
An individual who lives in an institution, in Pennsylvania or in another state, may be considered a resident of Pennsylvania if certain conditions are met. See Sections 323.23 Individuals Living in an Institution, and 323.24 Individuals Placed by the State in an Out-of-State Institution.
If two states cannot agree on an individual’s place of residence, then the individual is considered a resident of the state where he or she physically lives.
Updated February 14, 2012, Replacing January 31, 2009