PA Fair Care Eligibility and Availability


 

Funding for PA Fair Care is based on monies received from the federal government.

Pennsylvania is expected to receive approximately $160 million to administer PA Fair Care.

 

Acceptance into the program will be on a first come, first serve basis. Every year since the inception of the program, the department, in conjunction with the federal government, re-evaluates claim and administrative costs of the program to determine the number of individuals that may be enrolled in the program.

 

You may eligible to be enrolled in PA Fair Care if the following conditions are met: 

  • You are a resident of the Commonwealth of Pennsylvania.
  • You are a citizen or national of the United States or lawfully present in the United States.
  • You have been uninsured for six months prior to the date you are applying for coverage into the program.
  • You have a pre-existing condition.

You are NOT eligible for PA Fair Care if:

You are enrolled in Medicare (Part A and/or Part B), Medical Assistance (Medicaid), the Children’s Health Insurance Program (CHIP) or have had creditable health insurance coverage within the past 6 months. Creditable health insurance coverage includes individual or job-based health plan, including COBRA; adultBasic; TRICARE (military health insurance); VA health care; FEHBP (health insurance for Federal employees or retirees), including Temporary Continuation of Coverage (TCC); health benefit plan provided to Peace Corps workers; services provided by the Indian Health Service or by a Tribe or Tribal organization for treating your medical condition.

 

If I have a pre-existing condition, might I qualify for other programs?

Yes! You may qualify for Medical Assistance (MA), CHIP, Medicare or other resources. CHIP and MA do not have pre-existings condition exclusions. You may apply for PA Fair Care, but if you believe you are eligible for (but not enrolled in) these programs, we encourage you to apply to see if you qualify. These programs likely have broader benefits at a lower cost to you.

 

CHIP offers free or low-cost health insurance to all uninsured children and teens (up to age 19) who are not eligible for MA. For more information, see www.chipcoverspakids.com.

 

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