What benefits are available?
Benefits include but are not limited to:
- Emergency and Physician Services
- Mental Health Treatment
- Prescriptions
- Medical Supplies and Equipment
- Rehabilitation Services
Who is eligible?
To be eligible for PH95, the child must be:
- Under age 18 and a Pennsylvania resident;
- Lawfully present and provide or apply for a Social Security Number; and
- Disabled according to Social Security Administration (SSA) standards. Disabilities include physical, developmental, mental health, or intellectual.
Financial Eligibility Factors:
- The child’s countable income must be at or below 100% of the current year’s Federal Poverty Income Guidelines (FPIG).
- Uses SSA rules for determining countable income. Less than half of the child’s earned income is countable.
- Court-ordered child support and any RSDI income the child receives is excluded.
- Parental income must be verified but will be excluded in this category.
- The child must not qualify for any other Medicaid category. It is the category of last resort.
More Information
Learn more about the Children with Special Needs (PH95) Medicaid Category.
Learn more with these additional resources: