Medicaid Work Requirements in Pennsylvania

Pennsylvania's work requirements go into effect January 1, 2027 for adult Medicaid recipients ages 19 to 64 who do not have a dependent child under 14 and do not meet an exemption.

Updated October 30, 2026 · Based on official sources listed below · How we research

Jan 1, 2027

Start date

80 hrs or $580

per month, or half-time school

Medical Assistance

Medicaid expansion adults

1-877-395-8930

Work requirement reporting line (Philadelphia: 215-560-7226)

Check your situation in Pennsylvania

When it starts in Pennsylvania

August–September 2026: DHS began notifying current recipients by mail, text, and automated calls.
January 1, 2027: the requirement and 6-month renewals begin. Your renewal date is not shortened until after your next renewal.

Who has to meet it

The rule applies to people ages 19 to 64 in the Medicaid adult expansion group, unless they are pregnant, have Medicare, or are exempt. You meet it in a month with 80 hours of work, community service, a work program, or school (in any mix), by going to school at least half-time, or with at least $580 in monthly income.

You are exempt if, for example, you care for a child 13 or younger or a person with a disability, are pregnant or postpartum, are American Indian or Alaska Native, are medically frail, are a veteran with a total (100%) VA disability rating or TDIU, were in foster care at 18 and are under 26, are in drug or alcohol treatment, meet SNAP or TANF work rules, or left jail or prison in the last 3 months. See the full exemption list.

Court ruling, October 29, 2026. In Massachusetts v. Oz, a federal court struck down the CMS rule's extra "significantly impairs" test for the medically frail exemption. If you are in any of the five medically frail groups in the law, you qualify. Pennsylvania's Governor Josh Shapiro was one of the parties that sued, so the court also gave Pennsylvania six months of relief from federal enforcement of its medically frail decisions while it updates its systems. The January 1, 2027 start date did not change, and CMS may appeal. What the ruling means.

How Pennsylvania checks and how to report

Months checked: You report at application and renewal. Your renewal notice tells you the months being checked.

Upload documents through COMPASS or the myCOMPASS PA app, mail or bring them to your County Assistance Office, or call. If DHS needs more information it sends a letter, and you have 30 days to respond.

Other things to know in Pennsylvania

You can meet the rule with 80 hours a month of work, volunteering, training, or school, or with household income of at least $580 a month.
DHS says it will try to use information it already has to verify work and exemptions.

Official tools and contacts

Report and upload: COMPASS
Work requirement reporting line (Philadelphia: 215-560-7226): 1-877-395-8930
DHS H.R. 1 FAQ line: 1-877-883-6383
DHS Helpline (TDD 1-800-451-5886): 1-800-692-7462
PA DHS: Medicaid changes
Agency: Pennsylvania Department of Human Services (DHS)

Federal protections that apply in Pennsylvania

The state must check its own records before asking you for proof.
If it can't confirm you meet the rule, you get a notice and at least 30 days to respond, and your coverage continues meanwhile.
You get written notice and the right to a fair hearing before coverage ends, and you can reapply at any time.
If you lose Medicaid for not meeting the rule, you cannot get marketplace premium tax credits for those months. Learn more.

Frequently asked questions

When do Medicaid work requirements start in Pennsylvania?

January 1, 2027. Current members are usually checked at their first renewal on or after that date.

How many months does Pennsylvania check?

You report at application and renewal. Your renewal notice tells you the months being checked.

How do I report my hours or an exemption in Pennsylvania?

Who do I call about Medical Assistance work requirements?

Work requirement reporting line (Philadelphia: 215-560-7226): 1-877-395-8930
DHS H.R. 1 FAQ line: 1-877-883-6383
DHS Helpline (TDD 1-800-451-5886): 1-800-692-7462

Can I lose Medical Assistance right away if I don't meet the requirement?

No. Federal law requires a notice, at least 30 days to show you comply or are exempt, continued coverage during that time, and fair hearing rights before coverage ends.