This resource from Children’s Hospital of Philadelphia describes how to apply for PA medical assistance as secondary insurance.
Your child may be eligible for Pennsylvania Medical Assistance (PAMA) as secondary insurance because they have a chronic medical condition. Check with your child’s healthcare team to find out if their condition is eligible for secondary insurance. Take these steps to apply for state health insurance.
Start by getting a Letter of Denial from Social Security (SS) based upon income:
- Contact Social Security at 800-772-1213 and ask for the phone number of your local social security office.
- Call your local social security office and say, “I’d like to set up a telephone screening to see if my child is eligible for social security.” The representative will give you a date and time.
- Have income resources on hand when social security representative calls back at set appointment time.
- If you are found ineligible for social security, ask the representative for an “informal letter of denial.” The denial letter must be sent with the Pennsylvania Medical Assistance application (PAMA) when submitted to the County Assistance Office.
You can apply for secondary PAMA online at www.compass.state.pa.us or you can call the CHOP Family Health Coverage Program at 1-800-974-2125 to set an appointment or to have the PAMA application sent to you.
You must submit the following documents with your application:
- Copy of all household member’s birth certificates
- Copy of all household member’s social security cards
- Copy of primary health insurance card
- Copy of auto insurance card
- Copy of auto payment
- Letter of denial from Social Security
- Letter of medical necessity (In MyCHOP under “Letters”)
- Completed 586 physical form (In MyCHOP under “Letters”)
- Proof of income (tax return, recent month’s pay stubs or letter from employer).
- Copy of parent photo identification
- Copy of parent proof of citizenship (birth certificate, passport)
- Copy of a utility bill (gas, water, electric – needed to verify place of residence)
Selecting an HMO:
Once your application is processed, you will need to choose a PAMA HMO. When choosing an HMO, make sure that CHOP and your child’s primary care provider accept the same HMO plan.
If you have questions about which HMO plans CHOP does accept, visit Does CHOP Take My Insurance? Or call the Outpatient Pre-visit Financial Counseling at 215-590-3954 or 1-800-664-7855.
If you have questions about applying for PAMA contact your healthcare team via your MyCHOP portal.