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Pennsylvania DHS — Medicaid Application

Medical Condition

Do you have a medical condition that prevents you from working at least 80 hours a month?

Learn more about work requirements

Doctor Verification

Would you like us to reach out to your doctor to verify your diagnosis?

Doctor's Contact

Please provide your doctor's email address so we can send them the verification form.

What Happens Next

We've received your information. Here's what to expect:

  1. 1 We send a verification form to your doctor by email.
  2. 2 Your doctor has 10 business days to confirm your medical condition.
  3. 3 Once verified, your work requirement waiver is applied to your account.
  4. 4 You'll receive a notification confirming your updated Medicaid status.

Check your application status

Work Requirement Applies

Based on your response, you do not qualify for a medical frailty waiver at this time.

You are required to complete 80 hours per month of qualifying activities, which include:

  1. 1 Employment or self-employment
  2. 2 Job search or job training programs
  3. 3 Education or vocational coursework
  4. 4 Community service or volunteer work

If your circumstances change and you develop a medical condition that limits your ability to work, you can return here to request a waiver.

Learn more about work requirements and exemptions

Submit Your Own Documentation

You will need to provide medical documentation that supports your waiver request. Acceptable documents include:

  1. 1 A signed letter from your doctor describing your condition and its impact on your ability to work
  2. 2 Medical records or a diagnosis summary
  3. 3 A completed Pennsylvania DHS Medical Frailty Certification Form (MA-51)

Submit documents by mail or upload them through your Medicaid account portal. Documentation must be received within 30 days.