NEW PENNSLYVANIA MEDICAID ENROLLMENT PROCEDURES

To all Pennsylvania Medicaid Active providers, 

Please note that Medicaid is updating renewal guidelines.  You can assist your patients to help them ensure they renew their medicaid enrollment promptly to avoid denials.

Starting in 2027, Medicaid recipients will have new requirements to keep their coverage. As providers, you can help members navigate this transition and prepare.

LEARN MORE HERE:

https://www.pa.gov/agencies/dhs/resources/medicaid/medicaid-toolkit

 

Members will need to:

  • Renew their coverage every 6 months instead of every 12 months.

  • Complete work and community engagement requirements.  

Work Requirements and Six-Month Renewals 

Beginning in January 2027, some Medicaid (called Medical Assistance/MA in Pennsylvania) recipients will have to meet work requirements AND renew their Medicaid every six months (instead of every 12 months). This unprecedented change creates new rules and additional reporting requirements that could cause people who would usually qualify for Medicaid to lose coverage if they do not report properly and on time.

PA DHS has developed a communications toolkit to assist with outreach to help Medicaid recipients you work with understand these changes and what they must do to keep their Medicaid. Resources available will help you:

  • Share information about new Medicaid work requirements and six-month renewals that start in January 2027.

  • Remind Medicaid recipients to keep their contact information up-to-date with both PA DHS and the U.S. Postal Service so they do not miss important information and updates.

  • Educate Medicaid recipients you work with about exemptions to these rules so they understand what they must do to show they are exempt from work requirements.

  • Share information about ways Medicaid recipients can meet the work requirements.