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This is an application for Medical Assistance benefits. If you need help translating it, please contact your county assistance office, CAO.
Identity \u2014 Identity can be verified by a driver's license, state identification card or another piece of identification. Social Security Number (SSN) \u2014 A SSN must be provided for each person applying for Medical Assistance.
PA 1572 is the resource assessment form that a married Medical Assistance applicant should complete when he or she moves into a skilled nursing facility. If a skilled nursing facility resident applies for long term care Medicaid benefits in Pennsylvania, completion of PA 1572 is a requirement.
Application for Benefits (SNAP, Health Care, Cash Assistance) - PA 600. Application for Medical Assistance for Workers with Disabilities - PA 600WD.
PA 600 L (AS) 1/20. Page 1. Medical Assistance (Medicaid) Financial Eligibility Application. for Long Term Care, Supports and Services.
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People also ask

In 2022, the medically needy income limit (MNIL) is $425 / month for an individual and $442 / month for a couple. The \u201cspend down\u201d amount, which can be thought of as a deductible, is the difference between one's monthly income and the MNIL.

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