Medicaid Eligibility in Pennsylvania
Do You Qualify for Benefits?
Will I need long-term care?
Nearly 70 percent of people currently turning 65 will need some kind of long-term care.
70
percent
A lot of variation exists in the duration and level of long-term care. Medicaid planning can help ensure you receive the care you need.
Medicaid covers nearly half of all nursing home costs nationwide.
50
percent
Medicaid is needs-based and is designed to pay for long-term care but only once your own assets are extinguished.
How do I Qualify for Medicaid?
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Be a Pennsylvania resident Be a U.S. citizen or a qualified non-citizen Have a Social Security number Have a medical need for long-term care services
GENERAL MEDICAID ELIGIBILITY:
To be eligible, you must:
How do I Qualify Financially?
Medicaid places limits on income and resources for benefit eligibility.
Asset Limits
Income Limits
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The general income limit for Non Money Payment Medicaid is 300 percent of the federal benefit rate (FBR), which changes from year to year.
In 2021, the federal benefit rate is $794 per month.
The general income limit is 300 percent of $794, or $2,382 per month.
What Income is Counted?
FINANCIAL MEDICAID ELIGIBILITY:
Most types of income are counted including:
Pensions
Social Security
Withdrawals from an IRA account
Resource Limits
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For individuals with an income of 300 percent or less of the FBR, the resource limit is $2,000. Pennsylvania disregards an additional $6,000 in resources.
What Resources are Counted?
FINANCIAL MEDICAID ELIGIBILITY:
Most types of resources are counted including:
Cash
Bank Accounts
Stocks and bonds
FINANCIAL MEDICAID ELIGIBILITY:
Most types of resources are counted including:
IRA Accounts
Non-resident real estate
What Resources are not Counted?
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The home the person lives in, if the value is $525,000 One motor vehicle Burial plots and reserves, subject to certain limits
FINANCIAL MEDICAID ELIGIBILITY:
Resources not counted:
Spousal Impoverishment Rules
Special rules apply to married couples to protect the “community spouse,” or the spouse who stays in the community when the other needs nursing home care.
Spousal Impoverishment Rules
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The community spouse is protected from by being able to keep one-half of the couple’s total countable resources.
$26,076
COMMUNITY SPOUSE PROTECTIONS:
Minimum Community Spouse Resource Allowance
$130,380
Maximum Community Spouse Resource Allowance
Talk to an attorney to find out what planning strategy is right for you.
We give families the peace of mind of knowing the best possible planning is in place.