PA STATE AGENCIES PA ONLINE SERVICES WHAT WE OFFER HELPFUL LINKS ABOUT CONTACT US LOGIN / REGISTER Getting Started Apply Next Steps Submit Confirmation What To Expect Setup Returning Users Password Warning Privacy & Use of Your Information We will keep your information private as required by law. Everything you enter in this application will be kept confidential and will be used to administer benefits only. As part of the application process, we may need to retrieve information about you from third party electronic data sources. We will use the information provided by you and the electronic data sources to check your eligibility for benefits only. For more information on the security and confidentiality of this website, please read the Privacy Policy. For more information on the privacy of protected health information, please read the HIPAA Notice of Privacy Practices. For more information on data we receive and what you’re required to provide and report, please read the Rights and Responsibilities. You may print a copy of your Rights and Responsibilities at the end of your application. What information do I need to complete this application? Browser Compatibility Accessibility Privacy Policy HIPAA Notice of Privacy Practices Notice of Non-Discrimination