ACA Resource Center

Click here to download a form that you can complete and bring with you to your next family planning visit at Planned Parenthood of Western Pennsylvania to start the enrollment. Please note that you will also need to bring:

• a current Pennsylvania photo ID or other proof of PA residency such as a lease or utility bill
• your social security number (you do not need to bring the original card)
• current proof of income (30 days worth of paystubs, usually 2 to 3 paystubs)
• proof of citizenship or residency card (for citizens, a birth certificate or US passport; non-citizens must have been a permanent resident for at least 5 years)
• birth certificate or passport to prove you are a citizen. If you are not a US citizen, but have been a Permanent Resident for 5 or more years, you will need to bring your residency card.
• if you are legally married, please be sure to have spouse’s SSN and current proof of income

If you want to complete the application on your own prior to visiting, you can also apply to the Family Planning Services program by completing a full online application on COMPASS, the website for Pennsylvanians to apply for health and human services programs, or by completing a paper application called “Application for Health Care Coverage”. The paper application should be mailed to your County Assistance Office (CAOs) which you can find by clicking the link.