Medicaid for Assisted Living in Pennsylvania

Everything you need to know about Medicaid eligibility, waiver programs, income limits, and how to apply in Pennsylvania. Updated for 2026.

Assisted Living Waiver Status

No dedicated waiver — Pennsylvania does not have a specific assisted living waiver, but may provide coverage through No dedicated AL waiver (covered under Community HealthChoices).

Income & Asset Limits (2026)

Limits are approximate and subject to annual updates. Verify with your state Medicaid office.

	Individual	Married Couple
Income Limit	$2,829/month (300% of SSI)	$2,829/month (applicant)
Asset Limit	$2,000	$154,140 (community spouse)

Note: Certain assets are exempt from Medicaid calculations, including your primary residence (up to a state-determined equity limit), one vehicle, personal belongings, and pre-paid funeral arrangements.

Look-Back Period

60 months

Pennsylvania reviews all asset transfers made during this period before your Medicaid application date. If you gave away assets or sold them below fair market value during the look-back period, you may face a penalty period during which Medicaid will not pay for your care.

Important: Planning ahead is critical. If you anticipate needing Medicaid, consult with an elder law attorney well before the look-back period to understand your options.

How to Apply for Medicaid in Pennsylvania

Determine Eligibility

Review the income and asset limits below. Use our free Medicaid Eligibility Checker to get a quick estimate of whether you may qualify.

Gather Required Documents

You will need proof of income (Social Security statements, pension), bank statements, property deeds, insurance policies, and identification documents.

Submit Your Application

Apply through your state Medicaid office (online, by phone, or in person). Many states also accept applications through the federal Health Insurance Marketplace.

Complete the Assessment

If financially eligible, you will undergo a functional assessment to determine your level-of-care needs for assisted living or other long-term care services.

Receive Determination

Your state will notify you of approval or denial, usually within 45-90 days. If approved for a waiver, you may be placed on a waiting list depending on availability.

Visit Pennsylvania Medicaid Office

Check Your Medicaid Eligibility

Our free tool estimates whether you may qualify based on your income, assets, and state of residence.

Free Medicaid Eligibility Checker Cost Calculator

Frequently Asked Questions

Pennsylvania does not have a dedicated assisted living waiver, but may cover some services through other programs like No dedicated AL waiver (covered under Community HealthChoices). Eligibility depends on both financial and functional criteria.

For an individual, the income limit is approximately $2,829/month (300% of SSI). For married couples, the applicant spouse has the same limit, while the community spouse may retain up to $154,140 (community spouse) in assets. These limits are updated annually.

Pennsylvania has a 60 months look-back period. This means Medicaid will review all asset transfers made during this period before your application date. Gifts or transfers below fair market value during this time may result in a penalty period of ineligibility.

The Medicaid application process in Pennsylvania typically takes 45-90 days from submission to determination. Complex cases involving trusts, property, or recent asset transfers may take longer. If approved for a waiver program, there may be an additional waiting list period.

Your primary home is generally exempt from Medicaid asset calculations if you or your spouse lives in it, or if you intend to return home. However, Medicaid may place a lien on the home and pursue estate recovery after your passing. Consult with an elder law attorney for strategies specific to Pennsylvania.

Medicaid Guides for Other States

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