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Understanding Medicaid Eligibility Requirements in Pennsylvania


The cost of long-term care can be overwhelming. According to the Pennsylvania Health Care Association (PHCA), the median annual cost of a private room in a skilled nursing facility in the state exceeds $113,000. Medicaid, a crucial government program, helps cover these expenses. However, unlike Medicare, Medicaid qualification is not automatic and comes with strict financial eligibility requirements. Our Mechanicsburg Medicaid planning and asset protection lawyer outlines these requirements for long-term care.

Medicaid’s Stringent Income and Financial Resource Limits for Long-Term Care

Medicaid is federally funded but largely state-administered. The Pennsylvania Department of Human Services enforces strict income and financial resource thresholds for long-term care eligibility. Essentially, individuals must have low enough income and assets to qualify. Those with excess income or assets must spend down to meet the criteria.

Financial Eligibility Requirements for Medicaid in 2024

In Pennsylvania, Medicaid’s financial eligibility for long-term care varies based on marital status:

  • Unmarried Individuals: For 2024, the income limit is $2,829 per month, and the asset limit is $2,400.
  • Married Individuals: The income limit for couples is higher, with an increased asset limit of $3,000.

Certain assets are exempt from the Medicaid financial resource test. In Pennsylvania, the primary residence, one vehicle, and most personal effects are excluded when calculating total financial resources for Medicaid eligibility.

Proactive Planning: Protecting Your Assets with a Medicaid Compliant Trust

Early planning is essential to protect your assets from the high costs of long-term care. Setting up a Medicaid compliant trust is a strategic estate planning tool. This trust removes assets from your estate, ensuring they are not counted in Medicaid eligibility calculations. However, Medicaid’s five-year lookback period complicates last-minute planning. The agency reviews financial transactions from the previous five years, and any recent transfers may be invalidated. Therefore, a trust established too late may not fully protect your assets.

Contact Our Mechanicsburg Medicaid Planning and Asset Protection Attorney Today

At Keystone Elder Law P.C., our Mechanicsburg Medicaid planning lawyers are dedicated advocates for individuals and families. If you have questions about Medicaid eligibility requirements in Pennsylvania, we are here to help. Call us or contact us online for a confidential initial case review. From our Mechanicsburg office, we serve clients throughout Cumberland County and Pennsylvania.