Pennsylvania Medicaid long-term care
The eligibility rules and the actual application path in Pennsylvania. We link to the state agency at every step and we do not submit anything for you.
Quick answer
Does Pennsylvania Medicaid pay for home care?
Pennsylvania Medical Assistance can pay for long-term care both in nursing facilities and through Home and Community-Based Services (HCBS), but eligibility is a two-part test. For non-money payment (NMP) categories the 2026 individual income limit is $2,982 per month (300 percent of the federal benefit rate). Resource rules depend on income: if income is at or below that 300% FBR figure, the resource limit is $2,000 plus an additional $6,000 Pennsylvania resource disregard; if income is above 300% FBR, the resource limit is $2,400. Married couples also have community-spouse resource protections (2026 minimum protected share $32,532, maximum $162,660). The functional test requires a medical need for long-term care reviewed by a department-approved agent. Applications go through COMPASS or a county assistance office — not a home care agency. Confirm figures on the DHS page before you start.
What this page assumes you are paying for: what care costs in Pennsylvania — hourly, monthly and yearly, each figure with its source.
Who to apply with
Income and asset rules
Monthly income limit (NMP / 300% FBR, one person)
$2,982 USD/month (individual, 2026)
Non-money payment (NMP) SSI-related special gross income limit = 300% of the federal benefit rate, effective for 2026. Medically needy only (MNO) uses a different semi-annual net income test ($2,550 for one person) — see the DHS page.
Resource limit when income ≤ 300% FBR
$2,000 + $6,000 disregard USD (one person)
If income is at or below the 300% FBR income limit (currently $2,982), DHS states the resource limit is $2,000 with an additional $6,000 Pennsylvania resource disregard.
Resource limit when income > 300% FBR
$2,400 USD (one person)
If income is above the 300% FBR limit, DHS states the resource limit is $2,400. Excess income may still be workable with allowable medical expense deductions for facility care — confirm with the county assistance office.
Community spouse resource allowance (protected share)
$32,532 – $162,660 USD (2026 min–max)
For married couples, the community spouse may keep a protected share of combined countable resources: one-half of the couple’s total, but no less than $32,532 and no more than $162,660 for 2026. File Resource Assessment Form PA 1572 when one spouse enters LTC or is assessed for HCBS.
Home equity limit
$752,000 USD (2026)
Home equity at or under this limit may be excluded when the individual intends to return home or a spouse/dependent lives there — see DHS resource examples. Confirm current figure in the LTC eligibility appendix if your situation is close to the cap.
Community spouse monthly maintenance needs allowance (CSMMNA) — case-specific
Data pending verification. Not yet verified against the state agency for a single publishable figure on this page. We publish figures only after they are checked against the official source, with the source and review date shown. Check the state agency directly in the meantime.
Pennsylvania reviews transfers of assets for less than fair market value in a 60-month look-back before LTC/HCBS Medicaid. Uncompensated transfers can create a penalty period during which DHS will not pay for LTC services. That calculation belongs with the county assistance office or an elder-law attorney.
Home and community based services
- Home and Community-Based Services (HCBS) under DHS
Pennsylvania administers multiple HCBS programs; each has its own eligibility and service list. Financial Medicaid eligibility for LTC payment generally tracks the rules on this page, plus program-specific and level-of-care requirements.
- Community HealthChoices (CHC)
Managed long-term services and supports for many older adults and people with physical disabilities — confirm current CHC eligibility materials from DHS HealthChoices.
A waiver usually requires meeting both the financial rules and a functional (level-of-care) test. Waiting lists vary by waiver and by year.
How the application works
- 1. Apply through COMPASS or the county assistance office
Apply online via COMPASS, mail or deliver the Medicaid financial eligibility application for long-term care, or use the Consumer Service Center phone line for LTC/HCBS applications (1-866-550-4355). · COMPASS
- 2. Medical need / level-of-care review
A doctor completes a medical-need form; a department-approved agent reviews it and informs the county assistance office whether services are needed.
- 3. Financial review (income, resources, look-back)
The county assistance office reviews income, resources, and any transfers in the 60-month look-back. Married couples should consider filing Resource Assessment Form PA 1572.
- 4. Program enrollment
After financial and non-financial eligibility are met, enrollment into the appropriate facility or HCBS pathway proceeds through DHS processes — waiting lists and program capacity can still apply.
- 5. Choose services and providers
Detail depends on the specific HCBS program or facility placement; providers are not selected through this website.
Before you file
- Rules change annually — always confirm with Pennsylvania Department of Human Services (DHS).
- Transfers of assets in the look-back period can create a penalty period. That is a question for an elder law attorney, not a website.
- You can apply directly. You never have to pay a service to file for you.
Common questions
Is the income limit the only test?
No. You also need a medical need for long-term care reviewed by a department-approved agent, plus resource and look-back rules. Married couples have additional community-spouse protections.
Where do I apply?
Through COMPASS, a county assistance office, or the LTC/HCBS phone application line — not through a home care agency. We link DHS pages and do not submit anything for you.
Related
We are an independent informational and tools site. We are not a government agency, not a healthcare provider, and not a licensed referral agency under California CCR Title 22 or Florida Stat. 429.195. We do not place people into facilities and we do not charge families. Nothing here is legal, medical or financial advice — always confirm current rules with the state agency or a licensed professional.