Keystone First Medicaid helps people in Pennsylvania get health care coverage. It offers a variety of benefits to help people stay healthy and get the care they need, such as doctor visits, hospital stays, prescription drugs, mental health care, and dental care. Keystone First Medicaid also has programs to help people get healthy food, housing, and transportation. Individuals can qualify for Keystone First Medicaid based on their income, household size, and other factors.
Overview of Keystone First Medicaid Program
Keystone First Medicaid is a public health insurance program in Pennsylvania that provides comprehensive coverage to low-income children, pregnant women, and families. The program is administered by the Pennsylvania Department of Human Services (DHS) and is funded through a combination of state and federal funds.
Keystone First Medicaid offers a wide range of benefits, including:
- Medical care, including doctor visits, hospital stays, and prescription drugs
- Dental care
- Vision care
- Mental health care
- Substance abuse treatment
- Preventive care, such as checkups and screenings
Eligibility for Keystone First Medicaid is based on income and family size. In general, families with incomes below 138% of the federal poverty level are eligible for coverage. However, there are some exceptions to this rule. For example, pregnant women and children under the age of 19 are eligible for coverage regardless of their family income.
To apply for Keystone First Medicaid, you can submit an application online or by mail. You can also apply in person at your local DHS office. If you are approved for coverage, your benefits will start on the first day of the month following the month in which you applied.
Keystone First Medicaid is an important program that provides health insurance coverage to low-income families in Pennsylvania. The program helps to ensure that all children and pregnant women have access to the health care they need to stay healthy.
Eligibility
- Pregnant women
- Children under the age of 19
- Families with incomes below 138% of the federal poverty level
- Certain disabled individuals
- Individuals who are blind
Benefits
| Benefit | Covered Services |
|---|---|
| Medical care | Doctor visits, hospital stays, prescription drugs, mental health care, substance abuse treatment |
| Dental care | Cleanings, fillings, extractions, dentures |
| Vision care | Eye exams, glasses, contact lenses |
| Preventive care | Checkups, screenings, immunizations |
How to Apply
- Apply online
- Apply by mail
- Apply in person at your local DHS office
Eligibility Criteria for Keystone First Medicaid
Keystone First is a Medicaid program in Pennsylvania that provides health insurance to children, pregnant women, and families with low incomes. To be eligible for Keystone First, you must meet certain criteria. These criteria include:
- Age: Children must be under 19 years old. Pregnant women are eligible at any age.
- Income: Families must have a gross income that is at or below the federal poverty level (FPL). The FPL is updated each year, and the amount varies depending on the size of your family.
- Citizenship: Children and pregnant women must be U.S. citizens or qualified non-citizens.
- Residency: You must live in Pennsylvania.
In addition to these general requirements, there are some special rules that apply to different groups of people. For example, children with disabilities may be eligible for Keystone First even if their family’s income is above the FPL.
To apply for Keystone First, you can:
- Apply online at the Pennsylvania Department of Human Services website.
- Call the Pennsylvania Department of Human Services at 1-800-692-7462.
- Visit your local county assistance office.
Once you have applied, your eligibility will be determined within 45 days. If you are approved, you will receive a Keystone First ID card in the mail. Your coverage will start on the first day of the month following the month in which you are approved.
| Age | Income | Citizenship | Residency |
|---|---|---|---|
| Under 19 years old | At or below the federal poverty level (FPL) | U.S. citizens or qualified non-citizens | Pennsylvania |
Covered Services Under Keystone First Medicaid
Keystone First Medicaid is a health insurance program jointly funded by the federal government and the state of Pennsylvania. It provides comprehensive coverage to low-income children, pregnant women, and families. Keystone First Medicaid covers a wide array of services, providing access to quality healthcare for eligible individuals.
- Medical Services:
- Routine checkups and screenings
- Immunizations
- Sick visits
- Hospitalization
- Surgery
- Emergency services
- Specialist care
- Therapy and rehabilitation
- Prescription drugs
- Dental Services:
- Routine exams and cleanings
- Fillings
- Extractions
- Root canals
- Dentures
- Vision Services:
- Eye exams
- Glasses or contact lenses
- Mental Health Services:
- Therapy
- Counseling
- Medication management
- Substance abuse treatment
- Other Covered Services:
- Transportation to medical appointments
- Durable medical equipment
- Home health care
- Personal care services
- Family planning services
In addition to the services listed above, Keystone First Medicaid also covers a variety of preventive care services, such as immunizations, screenings, and health education. These services are essential for maintaining good health and preventing illness. Keystone First Medicaid also provides coverage for prescription drugs, which can be a significant expense for many families.
| Service | Covered | Copayment |
|---|---|---|
| Routine checkup | Yes | $0 |
| Sick visit | Yes | $5 |
| Hospitalization | Yes | $10/day (up to $300 per year) |
| Surgery | Yes | $100 |
| Emergency services | Yes | $0 |
| Specialist care | Yes | $10 |
| Therapy and rehabilitation | Yes | $10 per session |
| Prescription drugs | Yes | $0-$5 per prescription |
| Dental services | Yes | $0-$10 per service |
| Vision services | Yes | $0-$10 per service |
Keystone First Medicaid
Keystone First Medicaid is a health insurance program offered by the state of Pennsylvania to qualified low-income individuals and families. The program provides comprehensive health coverage, including doctor visits, hospital stays, preventive care, and prescription drugs.
Benefits of Keystone First Medicaid
- Comprehensive health coverage, including doctor visits, hospital stays, preventive care, and prescription drugs.
- No premiums or deductibles.
- Low copays for some services.
- Transportation to medical appointments.
- Free eyeglasses and dental care for children.
- Supplemental benefits, such as case management, nutrition counseling, and smoking cessation programs.
Limitations of Keystone First Medicaid
- Income and asset limits.
- Limited provider network.
- Some services may require prior authorization.
- Long wait times for appointments.
Who is Eligible for Keystone First Medicaid?
| Category | Income Limit |
|---|---|
| Pregnant women | 138% of the federal poverty level (FPL) |
| Children under 19 | 138% of the FPL |
| Parents and caretakers of children under 19 | 138% of the FPL |
| Disabled adults | 138% of the FPL |
| Seniors 65 and older | 138% of the FPL |
How to Apply for Keystone First Medicaid
To apply for Keystone First Medicaid, you can submit an application online or by mail. You can also apply in person at your local county assistance office. You will need to provide proof of your income, assets, and household size. If you are approved, your coverage will start on the first day of the month following the date of your application.
Thanks a bunch for taking the time to learn more about Keystone First Medicaid! I’m glad I could provide some helpful information and answer some of your questions. This program is an incredibly valuable resource for low-income and disabled individuals in Pennsylvania, and I hope you’ll consider applying if you or someone you know is eligible. If you have any further questions or if your situation changes, please don’t hesitate to reach out. Remember to check back later for more updates and information. Take care and stay well!