Apply For Health Care Only

As a first step in your application. we would like to ask you some brief questions to find out whether you should continue with COMPASS for Pennsylvania health care coverage programs or continue to the Health Insurance marketplace where you may apply for federal benefits and /or explore private health care options.
Please list the name and age of each person in your household:
Name: (Required)
Age: (Required)
Please enter age between 0 and 150.
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Does anyone have a disability, medical condition, or take an ongoing medication prescribed by a doctor?
Yes
No
Does anyone in the household want help paying for medical bills from the last 3 months?
Yes
No
Does anyone live in a medical or Long Term Living Services - Nursing Home and Related Facilities or have a physical, mental or emotional health condition that causes limitations in activities (like bathing, dressing, daily chores, etc.)?
Yes
No
Is anyone in the household pregnant?
Yes
No
Was anyone in the household in foster care on or after their 18th birthday?
Yes
No
What is the total gross annual household income?
$0.00 - $9999999.99