Assisted Living in Pennsylvania

Pennsylvania's Medicaid program is called Medical Assistance. For people 65 or older or with a disability, it pays for doctor visits, hospital care, prescriptions, and other medical care. It does not pay rent or room and board in a personal care home or assisted living residence. You need it to get Community HealthChoices long-term care, including its assisted living option.

There are two sets of limits. Healthy Horizons is full Medical Assistance for people with income at or below the federal poverty level. Long-term care has a higher income limit, $2,982 a month for one person in 2026, for people who need the level of care a nursing home provides and get it in a nursing home, at home, or in an approved assisted living residence. Its asset limit is $2,000 plus a $6,000 disregard, so you can have up to $8,000. If you get SSI, the county does not apply these limits to you.

If you are married and your spouse stays at home, your spouse can keep $32,532 to $162,660 in savings when you get long-term care.

Pennsylvania's Medicaid long-term care plans, called Community HealthChoices (CHC), can pay for your care in an assisted living residence instead of a nursing home. The state calls this In Lieu of Services (ILOS). You get the same long-term care services you would get in a nursing home, provided in the assisted living residence. Each month you pay the residence a share of your income, figured the same way as for a nursing home resident.

This option is small. It only works in assisted living residences that have a contract with the state and your CHC plan. On April 7, 2026, the state listed 17 approved residences in 12 counties. UPMC started the program in 2024, PA Health & Wellness joined in 2025, and AmeriHealth Caritas and Keystone First joined in 2026. Outside this program, the state says personal care homes and assisted living residences are typically not covered by Medicaid.

If you choose this option, you stop getting CHC home and community-based services.

If you get SSI and live in a licensed personal care home, Pennsylvania adds a state supplement of $639.30 a month in 2026. That raises your total SSI payment to $1,633.30. You keep $85 a month for personal needs, and the rest goes to the home for your room, board, and care. The home cannot charge you more than your total monthly income minus the $85.

The state's rules offer the supplement only in licensed personal care homes and certified domiciliary care homes. Assisted living residences, which Pennsylvania licenses separately, are not on that list. Domiciliary care homes are small homes, certified by the Department of Aging, for up to three people. There, the supplement is $634.30, for a total of $1,628.30.

You can get the supplement even if your income is too high for regular SSI, as long as it is less than the total payment for a personal care home.

Community HealthChoices is Pennsylvania's Medicaid managed care program for adults who have both Medicare and Medical Assistance, and for adults who need long-term care. It is run by three health plans: AmeriHealth Caritas, PA Health & Wellness, and UPMC Community HealthChoices.

If you need the level of care a nursing home provides, your plan can pay for services that help you stay at home. These include personal assistance with bathing and dressing, home health aides and nursing, adult day services, home-delivered meals, home adaptations, emergency response systems, and respite care. A service coordinator helps plan your care. These services do not pay rent or room and board.

Pennsylvania's version of PACE, the Program of All-Inclusive Care for the Elderly. A local LIFE provider gives you all of your medical care, personal care, day center services, meals, and transportation so you can keep living in the community. You can choose LIFE instead of Community HealthChoices.

The federal health insurance program for people 65 and older. Part A covers hospital stays and a short period of skilled nursing care after a hospital stay. Part B covers doctor visits, outpatient care, and medical equipment. Medicare does not pay for assisted living rent or for help with daily tasks like bathing and dressing. In 2026, Part B costs $202.90 a month with a $283 yearly deductible, and the Part A hospital deductible is $1,736.

Plans sold by private insurers that replace Original Medicare. They must cover everything Original Medicare covers, and many add drug, dental, vision, or hearing coverage. Plans, costs, and doctor networks vary by county.

Drug plans that add prescription coverage to Original Medicare. Each plan has its own list of covered drugs and its own premium. Most Medicare Advantage plans already include drug coverage.

A federal program, also called the Part D Low-Income Subsidy, that pays most Part D premiums, deductibles, and drug copays. People who get Medicaid, SSI, or a Medicare Savings Program qualify automatically.

Pennsylvania Medical Assistance programs that pay Medicare costs for people with limited income. In Pennsylvania these are part of Healthy Horizons, and the state calls paying your Medicare premiums "Buy-In." Anyone in QMB, SLMB, or QI-1 also qualifies for Extra Help.

Qualified Medicare Beneficiary (QMB), called Healthy Horizons cost-sharing, pays your Part A and Part B premiums, deductibles, and coinsurance. Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI-1) pay the Part B premium. You must apply for QI-1 every year, and the state approves it first come, first served.

Monthly income for retired workers, based on what you earned during your working years. You can spend it on anything, including assisted living. You need at least 40 work credits, which is about 10 years of work. Benefits can start at 62, and the monthly check is larger if you wait until full retirement age or later.

A monthly federal payment for people who are 65 or older, blind, or disabled and have very little income and savings. Getting SSI usually qualifies you for Medicaid as well.