392.1 General Policy

Reinstatement of Medical Assistance (MA) Benefits for MG99 Recipients Who Have Been Released from Incarceration, OPS180804 (Published August 22, 2018)

Facility code entry for children placed in pediatric facilities,  PMA18877392 (Published April 11, 2018)

 

An individual's eligibility for Medical Assistance (MA) is directly affected by the following:  

  55 Pa. Code § 161.22

 

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.

 55 Pa. Code § 161.22

Institutions fall into three groups:

 

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 June 1, 2018, Replacing April 12, 2018