PA Enrollment Services: Helping people with Medical Assistance choose a health plan and a doctor.

PA Enrollment Services: Helping people with Medical Assistance choose a health plan and a doctor.

mother and infant

Health benefits

After you join a health plan, you will get most of your Medical Assistance benefits through that health plan. All plans would give you the same benefits plus some extra services.

Your health benefits

After you choose a health plan, your plan will send you a handbook about your benefits and services. If you have not chosen a health plan yet, call your county assistance office to ask about benefits.

Benefits

The basic benefits are shown below. Your benefits will be based on your "category of assistance."

  • Doctor and hospital visits - including lab and x-ray services, emergency services and visits to specialists
  • Medicine - prescription drugs and over-the-counter drugs if the doctor gives you a prescription for them
  • Ob/Gyn care for women - pregnancy care, family planning and birth control
  • Dental care - routine dental care for children to age 21; benefits vary for adults
  • Vision care - medically necessary services including eye exams, glasses and lenses
  • Medical equipment - such as wheel chairs and diabetic supplies
  • Chiropractic care, physical therapy, foot care and home health care

Special needs

You may have a special health care need, such as asthma, heart problems or diabetes. Or, you may have special needs because of a problem in your life that could affect your health, such as homelessness, domestic violence, or children in substitute care.

If you have a special need, your health plan's Special Needs Unit (SNU) can give you some extra help. The SNU will work with you to give you the help you need to stay healthy. If you have special needs, call your health plan and ask for the Special Needs Unit.

Children, teens and young adults

Children up to age 21 can get many different kinds of services, such as regular checkups, shots (immunizations), glasses, braces, hearing exams, and hearing aids if needed.

Learn more about benefits for children, teens and young adults.

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