Medicaid Changes Coming to Pennsylvania: What You Need to Know

What is changing?

Two major changes may affect some adult Medicaid recipients starting Jan. 1, 2027:

1. Renewing Medicaid Every Six Months
   Some adults ages 19 to 64 will need to renew their Medicaid every 6 months instead of once a year.

2. Work and Community Engagement Requirements 

To meet the requirement, individuals must do one or more of these activities for at least 80 hours a month.

• Work at a job.

• Volunteer or do community service.

• Participate in a job training program

• Go to school or take educational classes.

You must tell the Pennsylvania Department of Human Services (DHS) about your activities or work. If you do not, you may lose your Medicaid. Requirements will be reviewed when individuals apply or renew coverage. DHS will use any one of the six months prior to their renewal date to meet the work and community engagement requirements. This requirement must be met at the time of applying.

What should you do now?

These changes will not take effect until 2027, but you can get ready now.

1. Make sure DHS has your correct address, phone number, and email address. Log in to dhs.pa.gov/COMPASS or the myCOMPASS PA app to check and update them.

2. Tell the U.S. Postal Service if you move. You can do this at USPS.com/move.

3. Sign up for text messages and emails from DHS at dhs.pa.gov/text. This will help you get updates faster.

DHS will contact you before changes are made to your benefits, if needed.

Who does not need to meet the new requirements?

Some people will not have to follow the new rules. You do not need to follow them if you are:

• Caring for a dependent younger than 14.
• Caring for someone with a disability.
• Pregnant or receiving postpartum coverage through Medicaid.
• Former foster care under the age of 26.
• Native American/American Indian or an Alaska Native.
• A veteran with a full disability rating.
• Getting treatment for alcohol or substance use.
• Considered medically frail or have special medical needs.
• A former inmate in prison or jail in the last 4 months.

Work or exemptions can be reported on the Medicaid application or renewal form. Documents and forms can be submitted through COMPASS, the myCOMPASS PA mobile app, or by calling the DHS Customer Service Center at 877-395-8930 (215-560-7226 in Philadelphia).