An individual's eligibility for Medical Assistance (MA) is directly affected by the following: 55 Pa. Code § 161.22
The type of institution he or she lives in.
The level of care he or she gets in that institution.
His or her age.
Whether an individual is a patient or an inmate also affects eligibility. Patients and inmates get different levels of medical services from different government agencies.
An inmate is an individual who lives in a public correctional institution.
A patient is an individual who lives in a medical institution or in a designated medical area of a public institution and who receives professional services to treat an illness, a disability, or pain. 55 Pa. Code § 161.22
Institutions fall into three groups:
Correctional institutions.
Medical institutions.
Other public institutions.
An inmate of a public correctional institution or a patient of a medical institution lives in the facility and does not make his or her home elsewhere. 55 Pa. Code § 161.22 42 CFR 435.1008 42 CFR 435.1009
Inmates of correctional institutions are eligible for MA only under certain conditions (See Section 392.2, and 392.21 Correctional Institutions.)
Patients of medical institutions, including institutions for mental diseases and psychiatric after-care facilities, may be eligible for MA. (See Section 392.3, Medical Institutions.)
Updated February 14, 2012, Replacing February 8, 2002