Due to new federal laws, Medicaid changes are coming and will affect a significant number of Philadelphians.

Some groups will experience changes on October 1, 2026; further changes are coming on January 1, 2027.

One Philly Medicaid Access is raising awareness of Medicaid changes so Philadelphians can prepare to keep health coverage for themselves and their families.
Three big things everyone can do to prepare:

  • Make sure your address is up to date with PA DHS. Don’t miss any important information about your benefits. Log in to COMPASS at dhs.pa.gov/compass to report changes.
  • Report address changes to USPS. Keep your address up to date with the United States Postal Service so mail about your benefits can reach you. Visit USPS.com/move.
  • Sign up for texts and email. Log in to COMPASS to receive updates, reminders, and alerts about your benefits. Opt in at dhs.pa.gov/text.

Pennsylvania Department of Human Services (PA DHS) is the source for the most up-to-date information on Medicaid changes.

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Who is affected?

  • 645,000 Philadelphians are on Medicaid, but many don’t know it.
  • 183,000 Philadelphians are part of the Medicaid Expansion group, which will experience most of the change—unless they have a documented disability or dependents under age 14.
  • The following health plans are Pennsylvania Medicaid plans. If you have one of these plans, you are receiving Medicaid and may be affected by these changes.
    • Geisinger Health Plan (GHP) Family
    • Jefferson Health Plans EverWell (formerly Health Partners Plans Medicaid)
    • Keystone First
    • UnitedHealthcare Community Plan of Pennsylvania
    • UPMC for You

Key dates

  • October 1, 2026: Medical Assistance for noncitizens ends
  • January 1, 2027: Work requirements
  • January 1, 2027: Eligibility renewals every six months

Medical Assistance for noncitizens ending (starting Oct. 1, 2026)

  • What we know
    • The County Assistance Office needs a copy of immigrants’ green cards.
    • Rules will not change for children under 21 and adults who are pregnant or up to 12 months postpartum.
    • If you’re losing coverage, get medical care, refill prescriptions and get medical equipment before Oct. 1.
  • Resources if you’re worried about losing coverage on October 1, 2026:

Work requirements: What they are, how you can fulfill them (starting Jan. 1, 2027)

Some adults ages 19-64 who don’t have a dependent child under 14 years old will need to show they are meeting work requirements and report to DHS.

  • You can meet work requirements by doing at least 80 hours a month of the following options:
    • Working
      • A job
      • Self-employment
      • Owning a business
      • Independent contractor (gig) work
      • Unpaid work or work in exchange for goods or services
    • Education
      • High school
      • GED programs
      • Community college
      • Four-year college or university
      • Graduate schools
      • Career or technical school
    • Job training
      • Approved program to help find, prepare for or keep a job
      • Includes certain federal, state, local and veterans’ employment and training programs
      • Programs that focus mostly on job search may not count
    • Volunteering or community service
      • Unpaid
      • With an organization such as a nonprofit, government office, school, church or another community group
      • www.panavigate.org can help you find an organization offering volunteer hours that help meet work requirements

You may also meet the work requirement if the total income of the countable people in your household is at least $580 a month before taxes.

Work requirements can be fulfilled through a combination of activities. For example, if you earn $290 a month at a job, do 10 hours a month of unpaid community service, and 30 hours a month of education, that satisfies the requirements.

Retroactive coverage: What’s new, what you need to do (starting Jan. 1, 2027)

Retroactive coverage timelines for medical expenses are decreasing.

Previously, Medicaid provided coverage for medical expenses that occurred up to three months before you applied.

Starting Jan. 1, 2027, that changes to:

  • Up to one month before application, for Medicaid expansion adults (ages 19-64)
  • Up to two months before application, for all other Medicaid recipients

Eligibility renewals: What’s new, what you need to do (starting Jan. 1, 2027)

Previously, Medicaid eligibility was checked every year.
Starting Jan. 1, 2027, Medicaid eligibility will need to be renewed every six months.

The first three things everyone should do

  • Make sure your address is up to date with PA DHS. Don’t miss any important information about your benefits. Log into COMPASS at dhs.pa.gov/compass to report changes.
  • Report address changes to USPS. Keep your address up to date with the United States Postal Service so mail about your benefits can reach you. Visit USPS.com/move.
  • Sign up for texts and email. Log in to COMPASS to receive updates, reminders and alerts about your benefits. Opt in at dhs.pa.gov/text.

Resources for those worried about losing coverage

News

Get more information on changes to Medicaid and what that means for you