Medicaid is one of the most critical public benefits programs for elderly Americans in need of long-term care. According to the National Center for Assisted Living (NCAL), Medicaid covers the cost of nursing home care for nearly two-thirds of residents nationwide. However, qualifying for Medicaid is not automatic—it is a means-tested program with strict income and asset limits. In this guide, our Mechanicsburg Medicaid planning attorney outlines what you need to know about becoming eligible for Medicaid in Pennsylvania.
What is Medicaid and How Does It Help with Long-Term Care?
Medicaid is a joint federal and state program that provides health coverage to eligible low-income individuals—including seniors who require long-term care services. For elderly Pennsylvanians, Medicaid can cover the high costs associated with nursing home care. Additionally, through Home and Community-Based Services (HCBS) Waivers, Medicaid may also pay for in-home care and other supports that allow seniors to remain in their homes and communities, rather than moving into an institution.
Income and Asset Limits for Medicaid in Pennsylvania (2025)
Eligibility for long-term care Medicaid in Pennsylvania is determined by strict financial criteria, which are updated annually. Here’s what you need to know for 2025:
- Monthly Income Limit: $2,901 for individual applicants.
- Asset Limits:
- $2,400 for applicants with income above $2,901/month.
- $8,000 for applicants with income below $2,901/month.
- $2,400 for applicants with income above $2,901/month.
Certain assets are exempt from Medicaid calculations, including:
- A primary residence (if equity is less than $713,000)
- One vehicle
- Some personal belongings and prepaid burial arrangements
Important: Medicaid has a five-year lookback period. Any gifts or transfers made during this time can trigger penalties, potentially delaying eligibility. However, transactions made before the lookback window—such as transferring assets to an irrevocable trust—are not subject to review.
How to Apply for Medicaid in Pennsylvania
Applying for Medicaid can be a complex and time-sensitive process. Proper preparation is key. Here’s what to expect:
- Submit an Application
You can apply:
- Online via COMPASS
- By phone at 1-866-550-4355
- In person at your local County Assistance Office (CAO)
- Or by mailing a completed paper application to the CAO
- Online via COMPASS
- Complete a Medical Assessment
After your application is received, the Independent Enrollment Broker (IEB) will arrange an in-person medical evaluation. This can be done at your home, hospital, or a nursing facility to determine your level of care needs. - Undergo a Financial Review
The CAO will review your income, assets, and financial history. Additional documentation may be required, so be prepared to respond quickly to any requests.
Why Medicaid Planning Matters
Without proactive Medicaid planning, seniors and their families may face unnecessary delays—or even denial—of benefits. Planning ahead helps protect valuable assets, avoid costly mistakes during the application process, and ensure that care needs are met without draining savings.
Contact Our Pennsylvania Medicaid Planning Lawyer Today
At Keystone Elder Law P.C., we help families navigate the complexities of Medicaid eligibility with care and clarity. Whether you’re planning in advance or facing an immediate need for long-term care, our Pennsylvania Medicaid planning attorney is here to guide you every step of the way. Call us today or contact us online to schedule a fully confidential consultation. From our Mechanicsburg office, we proudly serve families across the region with asset protection and elder law services.