Pennsylvania’s Medicaid agency lists veterans with a VA-determined total disability among the groups exempt from the state’s new Medicaid work requirement, which starts January 1, 2027. The rule asks adults ages 19 to 64 to show at least 80 hours a month of work or other approved activity, or income of at least $580 a month. South Dakota’s Department of Social Services lists the same veterans as excluded. For a veteran rated totally disabled, the 80-hour test is not supposed to apply at all, and Pennsylvania’s Department of Human Services gives three ways to report the exemption.
The question for a veteran is a narrow one. Pennsylvania’s list says “Veteran with a VA-determined total disability,” and the wording does not reach a veteran whose combined rating is lower, such as 70 or 90 percent. A veteran under 65 with a lower rating falls under the general rule unless another exemption fits, such as caring for a child under 14 or being medically frail. Veterans 65 and older are outside the rule on age alone, because the requirement covers ages 19 through 64.
For veterans with a VA total rating, the question before January 1, 2027 is whether the state already shows the exemption or still needs it reported. The SNAP & Medicaid Renewal Organizer lays out the new Medicaid work requirement and who is exempt, with a pack for each of the 51 states.
Get the Medicaid work-rule exemption guide for veterans in the SNAP & Medicaid Renewal Organizer →
Who else Pennsylvania exempts
Pennsylvania posts the exemptions on the same page that gives the January 1, 2027 start date. Besides veterans with a VA-determined total disability, the list names parents or caretakers of a child under 14 or of a person with a disability, women who are pregnant or on postpartum coverage, members of American Indian and Alaska Native tribes, and people in treatment for alcohol or substance use disorder. It also names former foster youth under 26, people released from jail or prison within the last four months, and people who are medically frail.
Two more routes lead out of the 80-hour test. People who already meet TANF work rules, or who are subject to SNAP work rules, are exempt, and so are temporary hardship cases such as a recent stay in a hospital or nursing facility or travel for medical treatment of a serious condition. The veteran exemption stands apart because it rests on a federal finding, the VA’s own rating decision, rather than on a household’s circumstances that can change from one month to the next.
South Dakota’s veteran exclusion and its one-month look-back
South Dakota applies the rule to Medicaid expansion adults ages 19 to 64, and its page lists “a veteran with a total disability rating” as an exclusion. The state’s wording differs from Pennsylvania’s, but the group is the same: veterans whose VA rating is total. The page names the other exclusions too, and the work test applies to expansion adults who fall outside every one of them.
South Dakota also spells out how the rule reaches people already enrolled. At the first regularly scheduled renewal in 2027, a current enrollee must show completion of the required 80 hours in at least one month since the last renewal. That look-back means the months between now and January already matter for anyone without an exemption. Expansion adults in South Dakota will also renew every six months starting January 1, 2027, so the check comes around twice a year.
The federal rule behind both states treats the veteran group as mandatory. In a September 2026 presentation to the Medicaid and CHIP Payment and Access Commission, staff members Janice Llanos-Velazquez and Linn Jennings listed “veterans with a total disability rating” among the specified excluded individuals who are not subject to the requirement. States must begin by January 1, 2027, and the presentation says a state must first try to confirm an exclusion using reliable information before it asks a person to prove hours worked. Nebraska, Montana, Iowa and Arkansas are starting earlier.
What a total VA rating is
The VA’s rating sets a veteran’s monthly disability compensation, and a 100 percent rating is the top of the scale. The VA lists $3,938.58 a month for a veteran alone with a 100 percent rating, effective December 1, 2025. Pennsylvania’s exemption turns on the rating determination, not on that payment, and its separate $580 income option is a different way to meet the work rule rather than a way out of it.
Pennsylvania’s page does not define “total” beyond the words on the list, and it does not say whether a veteran paid at the 100 percent rate through individual unemployability counts. Those are questions for the state, which runs an HR1 FAQ line at 1-877-883-6383. South Dakota’s page is equally brief on the point, and neither state publishes a list of the VA paperwork it accepts as proof.
Reporting a VA rating to Pennsylvania before January 1
The free route is Pennsylvania’s own Medicaid changes page. It says an exemption can be reported by calling 877-395-8930 (215-560-7226 in Philadelphia), by uploading documents through COMPASS or the myCOMPASS PA app, or by mailing or bringing documents to a County Assistance Office. The page lists the exemption but does not say which VA documents the state accepts, so the phone line is the place to settle that before sending anything.
If the Department of Human Services needs more information, it sends a letter, and the person has 30 days to provide it. The page warns that people who do not report may lose their Medicaid benefits. For a veteran with a total rating, the sequence to watch is a notice that arrives even though the exemption applies, followed by a 30-day clock that starts on the notice, not on January 1.
From October 8 to January 1 is 85 days, and Pennsylvania, South Dakota and the federal rule all use the same start. Pennsylvania’s version of the veteran exemption is a single line on a long list, which makes it easy to miss and easy to assume the state already knows. Under the federal rule, states are expected to check what they already hold before asking anyone to prove 80 hours, so a veteran’s record is the first place the exemption should surface.
One line on Pennsylvania’s list covers veterans
The veteran exemption is one line among many, and each state writes its own list and its own reporting route. The SNAP & Medicaid Renewal Organizer holds the new Medicaid work requirement and who is exempt, with a pack for each of the 51 states, so a veteran’s exemption and the steps to report it are in one place before January 1.
Get your state’s Medicaid work-rule exemption list in the Renewal Organizer →
This article was produced with AI assistance and reviewed by The Money Overview’s editorial team.
