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Utopia Talk / Politics / USians healthcare
Habebe
rank
Sun Mar 01 20:50:46
1. Has anyone here ever had county assistance HC?

What did it cover?

What were co-pays?

What were scripts?

What state?

Because, I basically got everything covered, a double hernia surgery, twice a year dental cleaning/polishing, had some cavaties drilled and filled and had ny wisdom teeth pulled at the oral.surgeon, had spinal tap, when I got sick Id go to my Dr. Or hospital and it was all covered.

For reference I have Philadelphia UPMC.

My scripts cost $1 max, about half are.free.
Habebe
rank
Sun Mar 01 20:56:05
https://medicaid.upmchealthplan.com/learn/whats-covered/
Habebe
rank
Sun Mar 01 21:00:49
I also get free gym/suana/pool access.

Just not at the Germantown branch, for that you need health partners.

But Roxborough and all other YMCAs are free.
Habebe
rank
Sun Mar 01 21:15:55
My jobs HC hasn't kicked in, but considering that basically anything a Dr. Calls medically neccesary is covered, i dont really care.

And also, my new insurance is through the AFL-CIO is free as a benefit, Im sure its pretty good too, maybe? Better (cosmetic surgery being the only thing UPMC really lacks)

My old job insurance covered 80% of cosmetic surgery/treatment.
williamthebastard
rank
Sun Mar 01 21:19:57
"county assistance HC"

So you are getting some form of disabled welfare to pay your medical bills

"If you’re 21 or older and receive long-term supports through Medicaid because you need help with everyday personal tasks, you may be eligible for enrollment in Community HealthChoices (CHC)."
Habebe
rank
Sun Mar 01 21:22:47
Ugh, I was making less than $50k/a year, because when I mocvd back up to Philly I didnt have a job.

Thats all you need to get it.

Even if you exceed that, if you have kids/pay child support etc. You can get it in PA.
williamthebastard
rank
Sun Mar 01 21:23:32
Since youre getting help with medical bills because youre considered handicapped, and on top of that apparently have filed for medical bankruptcy, I think I should let you think what feels best for you
Habebe
rank
Sun Mar 01 21:25:15
Are you drunk?
williamthebastard
rank
Sun Mar 01 21:26:01
"because you need help with everyday personal tasks, you may be eligible for enrollment in Community HealthChoices (CHC)."
obaminated
rank
Sun Mar 01 21:29:15
He isn't drunk, his brain doesn't work properly
Habebe
rank
Sun Mar 01 21:30:23
Here's what you need to know about qualifying for UPMC for You (Pennsylvania Medical Assistance/Medicaid) in Philadelphia:
Who Determines Eligibility
UPMC itself does not decide if you qualify — that's done by the Pennsylvania Department of Human Services (DHS) through your local County Assistance Office (CAO).
General Eligibility Requirements
You typically need to meet criteria in these areas:
Income — Must fall within Pennsylvania Medicaid income limits (generally up to 138% of the Federal Poverty Level for adults, which is roughly $20,000/year for a single person)
Residency — Must be a Pennsylvania resident
Citizenship/Immigration status — Must be a U.S. citizen or qualifying immigrant
Age/Category — Eligible groups include low-income adults, children, pregnant women, elderly, and people with disabilities

Well, I claimed 0 income when I applied like a year ago... been working since October 8th.

Still have coverage.

I guess its if you make less than $20k.


So I asked what happens if I make $1
21k


At $21,000/year as a single person in Pennsylvania, you're just slightly over the Medicaid income limit (138% FPL is roughly $20,783 for a single person in 2025).
What this means:
You would likely be just over the limit for Medicaid/UPMC for You, but that's not necessarily bad news — you'd fall into what's called the "coverage gap bridge" zone where you'd qualify for heavily subsidized marketplace insurance instead.
What you'd likely qualify for:
Pennie (Pennsylvania's health insurance marketplace at pennie.com) — at $21k/year you'd receive significant subsidies that could bring your monthly premium down to as little as $0–$50/month
Plans through Pennie can include UPMC coverage options
You may also qualify for cost-sharing reductions that lower your deductibles and copays
What to do:
Go to pennie.com and run a quick quote — it's free and shows your exact subsidy amount
Call 1-844-844-8040 (Pennie helpline) for free enrollment assistance
You can also get free in-person help through a navigator — Pennie's website can find one near you in Philadelphia
The good news is at $21k you'd get very affordable coverage.
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