Medicaid State Plan

Thank you for your interest in the Pennsylvania Medicaid State Plan.

0000 Table of Contents

0000.A Read Me Pennsylvania Medicaid State Plan

0000.B Superseding Pages

0000.C Approved MAGI Conversion Plan

0000.D Presumptive Eligibility for Hospitals - Supporting Materials

0001_Section 1

0001_Section 2

0003_Section 3

0004_Section 4

0005_Section 5

0006 Section 6

0007 Section 7

0008_Attach. 1.1 to 1.4

0009 Attach. 2.1A

0010 Attach. 2.2A

0011 Attachment 2.6

0012 Atachment 2.7 A

0013 Attachment 3.1A-3.1B

0014 Attachment 3.1B

0015 Attachment 3.1C

0016 Attachment 3.1D

0017 Attachment 3.1E

0018 Attachment 3.1F

0018.A Attachment.3.1L-1

0018.B Attachment.3.1L-2

0019 Attachment 3.2

0020 Attachment 4.11

0021 Attachment 4.16

0022 Attachment 4.17

0023 Attachment 4.18

0024 Attachment 4.19A

0025 Attachment 4.19B

0026 Attachment 4.19C

0027 Attachment 4.19D

0028 Attachment 4.19E

0029 Attachment 4.22

0030 Attachment 4.30

0031 Attachment 4.33

0032 Attachment 4.34

0033 Attachment 4.35

0034 Attachment 4.38

0035 Attachment 4.39

0036 Attachment 4.40

0037 Attachment 4.42

0038 Attachment 4.43

0039 Attachment 5

0040 Attachment 7

0041 MAGI-Based Eligibility Groups

0042 Eligibility Process

0043 MAGI-Based Income Methodologies

0044 Single State Agency A1-A3

0045 Residency

0046 Citizenship and Immigration Status

0047 Presumptive Eligibility for Hospitals

​Portal/Disaster SPAs note: SPAs submitted through the CMS MMDL and MACPro Portals, such as eligibility, Health Homes, cost sharing, and MAGI are not compatible with the current State Plan document. Therefore, these SPAs are listed here:

PA-22-0016 Postpartum CMS approval | PA-23-0001-A  | SPA 24-0005

Children's Health Insurance Program (CHIP) State Plan