Completing the Health Sustaining Medication Assessment Form (PA 1671)

http://www.dpw.state.pa.us/omap/provinf/maforms/omappa1671.pdf

I have a patient who is employable but needs daily medication. How can I get them Medical Assistance?
If they have gone to the County Assistance Office and applied for medical assistance, the caseworker should have given them form PA 1671

What does health sustaining medication mean?
It means any medication that the person needs in order to be employable. This includes medications for hypertension, diabetes, heart disease, or even pain medications if they need them in order to function.

Does a person have to be currently working to get this form of medical assistance?
No.

Why aren’t more people eligible under this category?
The income limits for this category are very low. For a single person, depending in which county they live, the income limits for a single person household is between $174 and $215/month.

If I know they have income above $205/month, why bother with the form?
Even if the person is above the income limit they should apply, because they may become eligible for spenddown. In spenddown, a person’s monthly medical expenses are deducted from their income to determine medical assistance eligibility. Once the medical deductions bring the applicant’s income under the MA limit, MA will pay remaining medical bills for either one month or six months depending on details of eligibility. However, if a physician is unsure, completing the form gives the applicant his or her best chance at obtaining medical insurance coverage under medical assistance.