How Medicaid Can Help Pay for Long-Term Care in Pennsylvania

Q: Why does Pennsylvania's Medicaid asset limit change based on income?

It's a two-tier rule: if your gross income is at or below $2,982/month (300% of the federal benefit rate), your asset limit is $8,000. If your income is above that line, the asset limit drops to $2,400. This surprises a lot of people since higher income usually doesn't mean a stricter asset test.

Q: Can I hire a family member as my caregiver in Pennsylvania?

Often, yes — through Services My Way (SMW), a self-direction option within Community HealthChoices that lets you choose your own care providers, including certain family members such as an adult child.

Published August 28, 2026 How we keep this accurate

This page is Pennsylvania-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere. Note: Pennsylvania officially calls this program "Medical Assistance," not Medicaid — the same program, different name on every form and county-office sign.

The rule that surprises people: your asset limit depends on your income

Most states use one flat asset limit regardless of income. Pennsylvania doesn't:

Your gross monthly income	Your asset limit
At or below $2,982/month	$8,000
Above $2,982/month	$2,400

Source: Pennsylvania Department of Human Services, Medical Assistance program guidance; figures effective 2026.

This runs backwards from most people's assumptions. Having slightly more income doesn't just create an income problem — it also cuts your allowed savings by more than two-thirds, from $8,000 down to $2,400. Understanding this before you apply can meaningfully change how you plan.

Community HealthChoices: Pennsylvania's home-care program

Community HealthChoices (CHC) is Pennsylvania's Medicaid managed care program for aged and physically disabled residents, which replaced the former Pennsylvania Department of Aging (PDA) Waiver — sometimes still called the "Aging Waiver" by people used to the old name. It covers adult day care, personal care assistance, home modifications, and home health services as an alternative to nursing home placement. Waivers aren't an entitlement — waitlists are common, so applying early matters.

Services My Way: hiring your own caregiver, including family

Within CHC, Services My Way (SMW) lets you self-direct your own care — choosing your own providers, including in many cases hiring a family member such as an adult child. If you're weighing whether a relative could be compensated for caregiving, this is the specific program to ask about.

The 2026 numbers that matter

Income limit: $2,982/month (300% of the federal benefit rate) — the same figure that determines which asset limit tier applies to you.

Spousal protection: the non-applicant spouse can keep up to $162,660 through the Community Spouse Resource Allowance.

60-month look-back applies to both nursing home Medicaid and CHC waiver applications — no exception by care type, unlike some other states.

If your income is over the limit

Pennsylvania offers a Medically Needy Only (MNO) pathway with a 6-month income limit of $2,550 for one person — medical expenses, including nursing facility bills, can be deducted to bring your countable income down to that threshold. This is a real option, but not always practical without help — an elder law attorney can determine whether it's worth pursuing for your situation.

What this actually costs without help

Pennsylvania's average nursing home cost is approximately $12,812/month — a real gap that makes understanding these income and asset tiers genuinely consequential, not just a bureaucratic detail.

How to actually start

Apply through your County Assistance Office (CAO) — confirm which asset limit tier applies to your specific income before assuming.

If your income sits close to $2,982/month, talk to an elder law attorney before applying — see Questions to Ask an Elder Law Attorney, since the difference of a few dollars in income can shift your allowed savings by thousands.

Common Questions

Why does Pennsylvania's Medicaid asset limit change based on income?

A two-tier rule: $8,000 asset limit if income is at or below $2,982/month, dropping to $2,400 if income is above that line.

What is Community HealthChoices in Pennsylvania?

PA's Medicaid managed care program for home and community-based long-term care, replacing the former Aging Waiver.

Can I hire a family member as my caregiver in Pennsylvania?

Often yes, through Services My Way, which allows self-directed care including hiring certain family members.