PA Fair Care Benefits


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


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.

Back to the PA Fair Care home page