By Kristy Warren

Changes to Medicaid funding, renewals, and eligibility made by the “One Big Beautiful Bill Act” (H.R. 1) are going into effect January 1, 2027, including new requirements for maintaining coverage and more frequent renewals for some Medicaid patients. 

The PA Dept. of Human Services (PA DHS) will inform patients affected by these changes and send them personalized instructions, so please be sure your address is up to date and carefully read all messages you receive from PA DHS.

To avoid losing coverage, it is important to understand how these changes may affect you and to renew your application before your personal deadline. If you have questions or need help with the new requirements, please contact your Medicaid caseworker (listed on your DHS packet) or county assistance office. 

Changes to Medicaid renewals and coverage are going into effect next January. The two biggest changes are:

Medicaid Renewals Due Every Six Months Instead of Yearly:

Beginning January 1, 2027, some recipients must renew their application every 6 months. If your next renewal date falls after January 1st, the six-month requirement starts from your next renewal application. For example, if your renewal is due April 15, 2027, you must re-apply by October 15, 2027. Your mailing from PA DHS will share your personal renewal date and details, including whether you'll need to renew every six months or annually.

New Work, Volunteer, or Community Engagement Requirements:

Adults aged 19-64 without a dependent under 14 years old must now log 80 hours each month of work, volunteering, education, work training, or a combination of these activities to maintain coverage. There are some exceptions, including certain medical or disability exemptions. Exceptions will require documentation. Visit pa.gov or call your local county assistance office to learn more about these requirements, how they apply, and how to document exceptions or work / volunteer / education hours.

Additional Resources and Support: 

• Learn more about these Medicaid changes and how they may apply to you at pa.gov.
  
  
• Use dhs.pa.gov or the Compass PA app to update your information, submit documentation, and renew your Medicaid application.
  
  
• For questions about these changes or help with documentation and applications, please reach out to your Medicaid caseworker (contact listed on your DHS packet) or your local county assistance office for help: Bradford County - 570-265-9186, Sullivan County - 570-946-7174, and Tioga County - 570-724-4051.
  
  
• The Pennsylvania Health Access Network (PHAN) can also provide guidance and support by phone at 1-877-570-3642 or by e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it..

If you have questions or need help with the new requirements, it is best to contact your Medicaid caseworker or local county assistance office for personalized support. They can clarify what changes apply to you and how you need to document to meet the new requirements or submit an exception. 

Each Medicaid patient has a personally assigned caseworker who can assist with questions, renewing coverage, or understanding documentation requirements. Caseworker information is listed on the mailing from the PA Dept. of Human Services (PA DHS) and the COMPASS website / phone app.

The local county assistance offices serving our area are:

Bradford County Assistance Office – 570-265-9186 or 1-800-542-3938
101 Hawkins Road
Towanda, PA 18848

Tioga County Assistance Office – 570-724-4051 or 1-800-525-6842
11809 Route 6
Wellsboro, PA 16901

Sullivan County Assistance Office – 570-946-7174 or 1-877-265-1681
11099 US-220
Dushore, PA 18614

Note: We recommend calling the Sullivan County Assistance Office directly to confirm the correct address and hours, as the state directory still lists their Laporte address, but we've been informed they recently moved from Laporte, PA to Dushore, PA. 

To avoid losing coverage, patients must keep their contact information up to date with PA DHS and stay vigilant for communications from the PA DHS so they understand how these changes may affect them, provide sufficient documentation, and renew their application before their personal deadline. For more information about these changes and how to check whether they apply to you, please read through pa.gov's Medicaid FAQs.

Not sure if these Medicaid changes might apply to you? The PA Dept. of Human Services (PA DHS) will be contacting patients and households who are affected by these changes, so it's important to make sure your contact information is up to date on your COMPASS app or portal to ensure you receive those communications. Watch for Medicaid communications by mail, phone, or text from PA DHS. Your Medicaid renewal packet will be sent in a pink envelope to help it stand out.

If you're concerned about losing healthcare coverage or higher costs, talk to your Laurel Health front office about our sliding fee scale and insurance enrollment support. All Laurel Health sites offer a sliding fee scale to income-eligible patients to help them receive the care they need. You may request an application from your Laurel Health office or from our billing department at 1-877-723-0589.

Our enrollment counselors are available to assist you with reviewing your eligibility for additional financial assistance. They can also help you enroll in Medicaid, CHIP, or commercial insurance plans on the PA marketplace Pennie.com. 

For more information about insurance enrollment assistance or applying for financial aid programs like our sliding fee program, call our certified application counselors at 570-723-3424. 

If you're concerned about losing healthcare coverage or being unable to afford care, talk to your Laurel Health front office about our sliding fee scale and insurance enrollment support. All Laurel Health sites offer a sliding fee scale to income-eligible patients to help them receive the care they need. You may request an application from your Laurel Health office or from our billing department at 1-877-723-0589.

Our enrollment counselors are available to assist you with reviewing your eligibility for additional financial assistance and aid resources. They can also help you enroll in Medicaid, CHIP, or PA marketplace Pennie.com plans. 

For more information about insurance enrollment assistance or applying for financial aid programs like our sliding fee program, call our certified application counselors at 570-723-3424.