Allentown Senior AdvisorWhat are Pennsylvania's 2026 Medical Assistance limits for long-term care?
For nursing facility and home and community-based waiver care, Pennsylvania's 2026 income limit is $2,982 a month (300% of the $994 SSI federal benefit rate) and the resource limit is $2,000, plus an additional $6,000 resource disregard when income is at or below that limit.
| Medical Assistance long-term care standard (2026) | Amount |
|---|---|
| Income limit (nursing facility and waiver) | $2,982 a month (300% of the $994 SSI federal benefit rate) for the nursing-facility and waiver categories |
| Resource limit | $2,000 plus an additional $6,000 resource disregard when income is at or below 300% of the FBR; $2,400 when income is above it |
| Look-back period for transfers | 60 months |
| Community spouse resource allowance | $32,532 to $162,660 |
| Minimum monthly maintenance needs allowance | $2,643.75 (effective July 1, 2025) |
| Maximum monthly maintenance needs allowance | $4,066.50 |
| Home equity limit | $752,000 |
| SSI federal benefit rate | $994 individual / $1,491 couple |
Sources: PA DHS Medical Assistance for long-term care; CMS 2026 SSI and spousal impoverishment standards.
Applicants with income above the limit may still qualify for nursing home care under the medically needy rules once their medical expenses are counted; a county assistance office caseworker or elder law attorney can say which category fits.
How does Medical Assistance protect a spouse who stays at home?
The community spouse keeps a resource allowance between $32,532 and $162,660 in 2026, and can receive part of the nursing home spouse's income to bring their own up to a monthly maintenance needs allowance of at least $2,643.75 (up to $4,066.50).
The home is generally excluded while a spouse lives in it, subject to the $752,000 home equity limit for the applicant. These rules are why couples should get advice before spending down savings, not after.
What is the five-year look-back in Pennsylvania?
When someone applies for long-term care Medical Assistance, the county assistance office reviews asset transfers made in the previous 60 months, and gifts or below-value transfers in that window create a penalty period during which Medical Assistance will not pay for long-term care.
Paying a family caregiver without a written agreement, adding a child to a deed and large cash gifts are the transfers that most often cause trouble. Keep receipts for everything spent on a parent's care.
Does Medical Assistance pay for a personal care home in Pennsylvania?
No, not for room, board or the home's personal care: Pennsylvania's Medical Assistance long-term care benefit pays nursing homes and home and community-based services through Community HealthChoices, and those waiver services do not cover personal care home or assisted living room and board.
That is the single biggest planning issue for Lehigh Valley families. A parent in a personal care home who runs out of money will usually need either SSI with the state supplement (if income is very low and the home accepts it) or a move to a nursing home that accepts Medical Assistance.
How do Lehigh Valley families apply for long-term care Medical Assistance?
Apply online through COMPASS, by phone through the Consumer Service Center at 1-866-550-4355, or at the county assistance office; the Area Agency on Aging separately assesses whether the person needs a nursing facility level of care.
The Lehigh County Office of Aging and Adult Services (610-782-3200), Northampton County Area Agency on Aging (610-829-4540) and Carbon County Area Agency on Aging (610-824-7830) can explain the steps and do the level-of-care assessment.
At a glance
| Medical Assistance long-term care does | Medical Assistance long-term care does not | |
|---|---|---|
| Nursing homes | Pay for care once a resident qualifies | Pay for a private room by choice |
| At home | Pay for waiver services through CHC | Pay round-the-clock family care |
| Personal care homes | Cover some services through the waiver in limited cases | Pay room and board |
Sources include 55 Pa. Code Chapters 20, 2600 and 2800, Pennsylvania DHS, Department of Health and Department of Aging pages, CMS, VA and CareScout rate tables as cited above; see our editorial standards.
