A Pennsylvania nursing home costs about $12,000 a month. Medical Assistance has rules that protect your family.
In Pennsylvania, Medicaid is called Medical Assistance, or MA. It’s the program that pays for most long-term nursing home care once a family’s own money runs out. This guide explains how it works in 2026, what the rules let a family keep, and the first calls to make. (Monthly cost: CareScout 2025 median, semi-private room.[14])
Watch: What Pennsylvania Law Lets Your Family Keep · about 2 minutes, plain English. Frank is our AI guide.
Reviewed September 2026 against official sources. Figures are for 2026 unless noted.
Medicare does not pay for long-term nursing home care — most families learn this in the worst week of their lives. See Medicare.gov.
How Pennsylvania pays for long-term care
Medicare doesn’t cover custodial care if that’s the only care someone needs.[15] In Pennsylvania, long-term care is paid through Medical Assistance in three main ways:
- MA long-term care pays for nursing home care. Your County Assistance Office decides eligibility.[1]
- Community HealthChoices (CHC) is Pennsylvania’s managed-care program for long-term services and supports, including care at home, for people who have both Medicare and Medical Assistance.[8]
- LIFE (Living Independence for the Elderly) is an all-in-one program for people 55 and older who need nursing-home-level care but can live safely in the community, in areas where it’s offered.[9]
The care-needs assessment: for Community HealthChoices, the Independent Enrollment Broker schedules an in-person assessment at home, in the hospital or in the nursing facility.[8] Your county’s Area Agency on Aging (Aging Well) determines whether the person is clinically eligible for nursing facility care.[10]
What care costs in Pennsylvania
Most families pay privately until Medical Assistance starts, so this is what’s at stake each month:
| Pennsylvania, 2025 median | Per month |
|---|---|
| Nursing home, semi-private room | $11,954 (about $143,445 a year) |
| Nursing home, private room | $13,688 |
| Assisted living | $6,480 |
| In-home care, 44 hours a week | $6,483 |
Source: CareScout Cost of Care Survey 2025.[14] Pennsylvania’s own average private-pay rate, the one it uses for transfer penalties, is $421.20 a day ($12,811.50 a month) in 2026.[3]
Why timing matters
- Pennsylvania can pay for care up to three months before the month you apply, but only if you apply in time to use it.[5] For applications made on or after January 1, 2027, federal law shortens that to two months.[16]
- A semi-private nursing home room in Pennsylvania costs a median of about $11,954 a month.[14]
- Families who don’t know the rules often cash in investments or retirement accounts at the worst possible time, not because they had to, but because nobody explained the options. Money that’s already spent can’t be protected.
- The longer a family waits, the fewer choices the law leaves. Gifts made now are counted for five years.[17]
Pennsylvania’s 2026 Medicaid numbers at a glance
These are the figures Pennsylvania uses in 2026. Most change every January, and the spouse’s income allowance changes every July.
| 2026 figure | |
|---|---|
| Asset limit (single applicant) | $2,000 plus a $6,000 disregard (about $8,000) if income is $2,982 a month or less; $2,400 if income is higher[1] |
| Income limit for the standard category | $2,982 a month. Above it, nursing home care can still be covered through the medically needy path.[2][1] |
| Personal needs allowance (nursing home) | $60 a month[2] |
| Assets the spouse at home can keep | Half of the couple’s countable assets, at least $32,532 and at most $162,660[1] |
| Spouse at home’s monthly income allowance | At least $2,705 (from July 1, 2026), up to $4,066.50[2] |
| Home equity limit | $752,000[2] |
| Transfer-penalty divisor | $421.20 a day ($12,811.50 a month)[3] |
| Look-back period for gifts and transfers | 60 months (5 years)[17] |
| Back-dated (retroactive) coverage | Up to 3 months before the month of application; 2 months for applications on or after January 1, 2027[5][16] |
| How long it takes | The County Assistance Office decides within 30 days, or tells you in writing if it needs up to 45[6] |
Where Pennsylvania is different. Pennsylvania isn’t a Qualified Income Trust state: income over $2,982 is handled through the medically needy path for nursing home care.[1] The asset limit depends on income, and the spouse at home keeps half of the couple’s countable assets within a floor and a ceiling, rather than a single fixed amount.[1] Pennsylvania can also pay for up to three months before the application month, a window that shrinks to two months on January 1, 2027.[5][16]
What Pennsylvania’s rules let a family keep
Medical Assistance isn’t only for families with nothing. Sooner or later, nearly every family is touched by long-term care, directly or through a parent. Pennsylvania’s rules name specific things a family is allowed to keep.
The home
The home is protected within the $752,000 equity limit, or when a spouse or dependent relative lives there.[1][2]
The spouse’s share
The spouse at home keeps half of the couple’s countable assets, never less than $32,532 and never more than $162,660, plus a monthly income allowance.[1][2]
One vehicle
One motor vehicle is not counted.[1]
Burial spaces and funeral funds
All burial spaces and plots, including markers, are protected, along with revocable and irrevocable burial reserves within set limits.[1]
An example, using Pennsylvania’s 2026 numbers. Dorothy, 86, is moving into a nursing home in Allentown. She and her husband Frank own their home and have $200,000 in countable savings. The home stays protected because Frank lives there.[1] Frank’s share is half of the countable assets, $100,000, which falls between Pennsylvania’s $32,532 floor and $162,660 ceiling.[1] Dorothy’s income is $3,300 a month, over $2,982, so her own asset limit is $2,400 and she qualifies through the medically needy path rather than a trust.[1] That leaves about $97,600 above what the rules let them keep, which is what the rules expect to go toward care, or be spent in ways they allow, before she qualifies. Once she does, she keeps $60 a month for personal needs, and if Frank’s own income is under $2,705, part of hers can go to him.[2] (The names and amounts are made up to show how the rules fit together. Every family’s numbers are different.)
If income is over the limit
Pennsylvania is not a Qualified Income Trust state. For nursing home care, a person whose income is over $2,982 a month can still qualify through the medically needy path: the expected cost of nursing home care over six months counts as a medical expense that reduces their income.[1]
Care at home is different. Someone with income over $2,982 can’t qualify for the home and community-based waiver categories in the medically needy group, though other Medical Assistance categories may still apply.[4] That difference is one reason families in Pennsylvania should look at their options before choosing where care happens.
Gifts, transfers and the 5-year lookback
Medical Assistance looks back five years at gifts and transfers made for less than their value.[17] Pennsylvania calculates the penalty with its daily rate of $421.20: a $50,000 gift works out to about 119 days, roughly four months, when Medical Assistance won’t pay for long-term care.[3]
Past gifts don’t always mean a penalty. Transfers to a spouse are generally exempt, and federal law says no penalty applies if all of the transferred assets are returned. How these rules apply depends on the details, so check before relying on them.[17] Get the facts before moving any money.
Estate recovery in Pennsylvania
Pennsylvania’s Estate Recovery Program seeks repayment from the estates of people who were 55 or older when they received long-term care Medical Assistance, including nursing home and home and community-based services. Questions go to DHS at (800) 528-3708.[11]
First steps for your situation
Where your family is today changes what to do first.
Already in a nursing home, or leaving the hospital
- Ask the hospital or nursing home social worker to help start the Medical Assistance application, and ask which county office handles it.
- Apply now. Pennsylvania can reach back up to three months before the application month, but only for months you apply in time to claim.[5]
- Gather income statements, recent bank statements and property records.
- List any gifts or transfers made in the last five years.
- Don’t spend down or give away money until you understand the rules. The order of steps matters.
Planning ahead
- Compare where care will happen: nursing home, home care through Community HealthChoices, or LIFE. The income rules differ.
- Remember the five-year look-back before making any gifts.[17]
- Know the spouse’s share: half of the couple’s countable assets, up to $162,660.
- Review your estate plan. Standard estate moves aren’t always Medicaid-friendly.
- Start early. The longer a family waits, the fewer choices the law leaves.
How our free case review works
Short 60-second survey
A few questions about the care situation — a parent, a spouse, or yourself — and the general asset picture.
Free 30-minute case review
A real conversation about your family’s situation and an honest read on what Pennsylvania’s rules allow in your family’s case.
Your family’s next steps
A clear, step-by-step look at how the rules apply to your family, so you know what to ask and what to do next.
How to apply in Pennsylvania
- Apply online at COMPASS, with a paper application at your County Assistance Office, or through the Independent Enrollment Broker at 1-877-550-4227 (TTY 1-877-824-9346).[7]
- Schedule the care-needs assessment. For Community HealthChoices, the Independent Enrollment Broker arranges an in-person assessment.[8]
- Send what the County Assistance Office asks for. It decides within 30 days, or tells you in writing if it needs up to 45.[6]
- Ask about the retroactive period if care has already started. For nursing home care, the months before application need a form certifying the need for care during those days.[5]
Free help in Pennsylvania
These programs are free and independent of Medicaid Answers.
Independent Enrollment Broker (IEB)
Applications and assessments for long-term services at home. · 1-877-550-4227
Community HealthChoices Helpline
Questions about Pennsylvania’s managed long-term care program. · 1-844-824-3655
All-inclusive care for people 55+ who can live in the community.
State Health Insurance Assistance Program (SHIP)
Free, unbiased counseling on Medicare and Medicaid. · 1-877-839-2675
Finds your county’s Area Agency on Aging. · 1-800-677-1116
About our free case review
A free 30-minute phone or video conversation with the Medicaid Answers team for families in Pennsylvania whose savings, home or other assets make Medical Assistance eligibility complicated — the situations where the rules are hardest to navigate alone. We listen to your family’s situation, explain how Medical Assistance’s long-term care rules apply to it, and point you to next steps and official resources. It’s free, and what you do afterward is entirely your choice.
If your family needs hands-on help, we’ll explain your options and point you to the right kind of help, such as Pennsylvania’s free counseling programs, legal aid, an elder law attorney or a Medicaid planner.
- If the person needing care has little or no savings, you can usually apply directly with your County Assistance Office; the steps under “How to apply” walk you through it.
- It is educational, not legal or financial advice.
- It doesn’t replace your County Assistance Office, which makes every eligibility decision.
If a hospital discharge or nursing home admission is happening now, reach out this week. Applications and assessments take time, and starting early keeps more options open.
Questions families ask
Can a Pennsylvania nursing home make adult children pay?
What if we already gave money or property to family?
What if the income is over Pennsylvania’s limit?
Why is the asset limit sometimes $8,000 and sometimes $2,400?
What changes on January 1, 2027?
Who decides whether someone needs nursing home care?
Sources
Figures and rules on this page come from these sources. Reviewed September 2026.
- Pennsylvania Department of Human Services (DHS), “Medicaid and payment of long-term care”. www.pa.gov/agencies/dhs/resources/aging-physical-disabilities/medicaid-payment-long-term-care
- PA DHS Long-Term Care Handbook, 468 Appendix A (eligibility and payment standards), updated September 10, 2026. services.dpw.state.pa.us/oimpolicymanuals/ltc/468_Eligibility_and_Payment/468_Appendix_A.htm
- PA DHS Long-Term Care Handbook, 440 Appendix A (resources and average private pay rates). services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm
- PA DHS Long-Term Care Handbook, 468.2 (MA long-term care eligibility, including home and community-based services). services.dpw.state.pa.us/oimpolicymanuals/ltc/468_Eligibility_and_Payment/468_2_MA_LTC_Eligibility_Step_1.htm
- PA DHS Long-Term Care Handbook, 404.1 (applications and the retroactive period). services.dpw.state.pa.us/oimpolicymanuals/ltc/404_Application/404_1_General_Policy.htm
- PA DHS Medical Assistance Handbook, 303.2 (rights and responsibilities, processing time). services.dpw.state.pa.us/oimpolicymanuals/ma/303_General_Information/303_2_Rights_and_Responsibilities.htm
- PA DHS, “Apply for long-term care services”. www.pa.gov/services/dhs/apply-for-long-term-care-services
- PA DHS, “Apply for Community HealthChoices”. www.pa.gov/services/dhs/apply-for-community-healthchoices
- PA DHS, Living Independence for the Elderly (LIFE) program. www.pa.gov/services/dhs/enroll-in-the-living-independently-for-the-elderly-program-life
- PA DHS, long-term care for people coming from out of state (level-of-care determinations by the Area Agency on Aging). www.pa.gov/agencies/dhs/resources/for-providers/ltc-providers/out-of-state-seeking-ltc
- PA DHS, Estate Recovery Program. www.pa.gov/agencies/dhs/resources/for-residents/estate-recovery
- 23 Pa.C.S. § 4603, Relatives’ liability (Pennsylvania’s filial support law). www.legis.state.pa.us/WU01/LI/LI/CT/HTM/23/00.046.003.000..HTM
- Health Care & Retirement Corp. of America v. Pittas, Pennsylvania Superior Court, 2012. www.pacourts.us/assets/opinions/Superior/out/A36025_11.pdf
- CareScout, Cost of Care Survey 2025, state median cost tables (data collected July–November 2025, published March 2026). assets.carescout.com/x/5c90319b6a/298701.pdf
- Medicare.gov, “Nursing home care”. www.medicare.gov/coverage/nursing-home-care
- Centers for Medicare & Medicaid Services, informational bulletin on Public Law 119-21, November 18, 2025 (retroactive coverage from January 1, 2027). www.medicaid.gov/federal-policy-guidance/downloads/cib11182025.pdf
- 42 U.S.C. § 1396p (transfers of assets, the 60-month look-back and exempt transfers). www.law.cornell.edu/uscode/text/42/1396p