Once enrolled in PA Fair Care, you will have access to the following benefit package:
Preventive care
Physician services
Diagnosis and treatment of illness or injury, such as laboratory tests, X-rays, wound dressing and casting to immobilize fractures
Therapy services
Skilled nursing
Maternity and newborn care (up to 31 days)
Inpatient hospitalization
Outpatient hospital services
Emergency accident and medical care
Prescription medications
Durable medical equipment
Serious mental illness
Hospice
Click here for a detailed chart of in network / out of network expenses.
PA Fair Care will NOT cover:
services not medically necessary;
services or supplies that are experimental or investigative except routine costs associated with clinical trials;
hearing aids, hearing examinations/tests for the prescription/fitting of hearing aids, and cochlear electromagnetic hearing devices;
assisted fertilization techniques such as in vitro fertilization, GIFT and ZIFT;
alternative therapies/complementary medicine;
dental care, including dental implants and nonsurgical treatment of temporomandibular joint syndrome (TMJ);
routine foot care, unless medically necessary or associated with the treatment of diabetes;
foot orthotics, except for orthotics and podiatric appliances required for the prevention of complications associated with diabetes;
contraceptive devices;
immunizations for travel or employment;
service or supplies payable under workers’ compensation, motor vehicle insurance, Medicare or other legislation of similar purpose;
cosmetic services/supplies;
vision care;
services for mental health conditions other than serious mental illness;
abortions, except in cases of rape or incest, or where the life of the woman would be endangered.
