Medical Assistance long-term care,
in plain English.

The numbers that matter in Pennsylvania

• Penalty divisor (2026): $12,812/month — every $12,812 in gifted assets during the 5-year lookback = 1 month of Medicaid ineligibility.
• Nursing-home cost (2026, semi-private): ~$10,159/month = $121,908/year.
• CSRA ceiling: $162,660 (community-spouse resource allowance).
• MMMNA band: $2,643.75 to $4,066.50/month (minimum monthly maintenance needs allowance).
• Home equity limit: $752,000.
• Applicant asset cap: $2,000 (non-exempt).
• Applicant income cap: $2,901/month (state-federal common threshold, 2026).
• Managed long-term care: Yes — enrollment required after eligibility.
• Estate recovery posture: Minimum (only TEFRA-required).

Programs and acronyms in Pennsylvania

If you're searching for help with long-term-care Medicaid in Pennsylvania, these are the names and acronyms you'll encounter on state-agency forms, in elder-law conversations, and in nursing-facility paperwork.

• Medical Assistance — Pennsylvania Medicaid. The state's Medicaid program brand.
• Pennsylvania Department of Human Services (DHS) — administers Medical Assistance and processes long-term-care eligibility decisions.
• Community HealthChoices (CHC) — Pennsylvania's mandatory MLTSS for dual-eligibles and adults 21+ with disabilities — capitated managed care covering nursing-facility and HCBS.
• OBRA Waiver — HCBS waiver for Pennsylvanians 18-59 with severe physical disabilities not eligible for CHC.
• Living Independence For the Elderly (LIFE) — Pennsylvania's PACE program — combined Medicare/Medicaid benefits with all-inclusive day-center model.
• COMPASS — Pennsylvania's online Medicaid application portal: www.compass.state.pa.us/
• OLTL — Office of Long-Term Living (Administers CHC and OBRA).
• OMAP — Office of Medical Assistance Programs (Pennsylvania Medicaid agency).
• AAA — Area Agency on Aging (Local CHC enrollment broker).

The Pennsylvania planning levers

Every Medicaid plan in Pennsylvania pulls some combination of five levers: (1) community-spouse asset re-allocation inside the CSRA ceiling, (2) spend-down on exempt assets (home improvements, new car for the community spouse, pre-paid funeral), (3) irrevocable trust transfer outside the 5-year window, (4) caregiver-child exception or disabled-child exception on the home, and (5) personal-service contracts paying a family member for documented caregiving hours.

Which lever fits depends on the specific assets, the crisis timeline, and — critically — whether the applicant is already in a facility. If a family member is already admitted, the playbook narrows to levers (1), (2), and (5) only.

What planning looks like, by timeline

5+ years out: full menu available. Irrevocable-trust transfers, gifting, long-term-care insurance — all work if executed cleanly. Time is the most valuable asset in Medicaid planning.

1–5 years out: half-menu. Transfers still trigger the lookback but a known penalty period can be absorbed by private pay. Community-spouse re-allocation is still a big lever.

Already in a facility: crisis planning. Most gifting is off the table. Spend-down, community-spouse allowance, personal-service contracts, and exempt-asset purchases become primary. See the crisis playbook.