Assisted Living in Pennsylvania
Pennsylvania has a population of almost 13 million inhabitants. Seniors aged 65 and older comprise 18.7% of that total, which is larger than the national average of 16.5%. The state’s cost of living is eight points below the national average, making it an attractive option for seniors. Pennsylvania exempts all income from Social Security and payments from 401(k)s and IRAs.
Pennsylvania has two kinds of assisted living facilities: Assisted Living Residences (ALR) and Personal Care Homes (PCHs). Personal care homes are smaller than ALRs and operate under different legal requirements. PCHs don’t offer the same amenities as ALRs but cost less. According to the Genworth Cost of Care Survey 2021, the average cost of assisted living in Pennsylvania averages $4,100 a month.
This guide offers seniors information on assisted living costs and financial assistance options throughout the state, as well as some free and low-cost resources available to seniors in Pennsylvania.
How Much Does Assisted Living Cost in Pennsylvania?
According to the Genworth Cost of Care Survey 2021, Pennsylvania’s monthly assisted living cost of $4,100 is reasonable for the region. It’s also $400 less expensive than the national average of $4,500 a month. West Virginia is more costly at $4,160 per month. New York’s monthly average is $4,580, while Ohio’s is approximately $500 more at $4,635. The neighboring state with the highest cost of assisted living is Maryland, which averages $4,900 a month.
The United States
The Cost of Assisted Living in Pennsylvania’s Top Cities
The cost of assisted living in Pennsylvania’s cities and towns can vary by almost $3,000. Scranton, located in the northeastern part of the state, has the lowest assisted living costs in Pennsylvania, averaging $2,875 a month. The highest prices can be found in Reading, where seniors pay about $5,720 per month. Harrisburg, the state capital, averages $4,828 a month. Pittsburgh costs $3,250 a month, while Allentown averages $4,784 a month. In Lancaster, assisted living residents pay one of the most expensive rates in the state at $5,550 per month. Philadelphia, Pennsylvania’s largest city, has the second-highest cost of assisted living of $5,685 a month.
The Cost of Assisted Living Versus Other Types of Care
Pennsylvania seniors have a selection of several types of senior living options. The least expensive is adult day care which averages $1,625 a month. A semiprivate room in a nursing facility is the most expensive, averaging $10,043 a month. For seniors who wish to age in place, there are two options. Home care, which provides seniors with assistance with several activities of daily living (ADLs), averages $4,957 a month.
Home health care, which includes many of the same activities as home care but adds medical care, can be more expensive in many states. However, in Pennsylvania, home health care averages the same cost as home care of $4,957 a month. Adult day health care is the least expensive option at $1,625 per month; however, this level of care is only provided during the day and leaves seniors to find other solutions for overnight care.
Home health care
Adult day health care
Nursing facility (semiprivate room)
Can You Use Medicaid to Pay for Assisted Living in Pennsylvania?
Medicaid, known as Medical Assistance in Pennsylvania, does not directly provide financial assistance for seniors residing in assisted living facilities. Some seniors may be eligible for the Aging Waiver, which provides financial aid to seniors who want to remain in their communities or homes.
Pennsylvanians aged 60 and older may be eligible for the Aging Waiver, which can help them meet some of the financial costs associated with assisted living.
Medicaid’s Coverage of Assisted Living in Pennsylvania
The Pennsylvania Aging Waiver provides financial assistance and services for seniors who wish to remain in their communities or homes. This includes personal care assistance in domiciliary care homes, a form of adult foster care. In domiciliary care, older adults remain in their communities by living with families to whom they are not related.
Some of the services provided by the Aging Waiver include:
- Assistance with ADLs
- Therapeutic counseling services
- Assistive technologies
- Nursing services
- Physical therapy services
- Speech and language therapy
- Nutrition counseling services
- Nonmedical transportation services
Waiver Programs for Assisted Living in Pennsylvania
The Aging Waiver is open to Pennsylvanians aged 60 and older who meet the following requirements:
- Reside in Pennsylvania
- A US citizen, a permanent resident or a documented alien
- Possess a Social Security number
- Require a level of care that makes them eligible for a skilled nursing facility
- Meet the Aging Waiver’s financial requirements as determined by their local County Assistance Office
For information on applying for the Aging Waiver and assistance in determining if you are eligible, contact your local Area Agency on Aging or the Office of Long-Term Living Bureau of Participant Operations at (717) 787-8091.
Eligibility for Medicaid in Pennsylvania
Seniors who wish to apply for Medicaid need to meet the financial limitations of the Medical Assistance program. Individuals cannot earn more than $18,075 a year or have assets above $2,000. In two-person households where only one person is applying, the income limit is $24,353, but the non-applying spouse can have assets up to a limit of $137,400.
Note: In Pennsylvania, individuals who need assistance with activities of daily living and meet “level of care” requirements have special income eligibility limits in order to qualify for waiver programs as well as full Medicaid. The income limit for these individuals is $30,376 per year (only applicant’s income is counted), and the asset limit is $8,000. If the individual is married, the spouse’s assets are included in the asset limit, while their income is not.
2022 Medicaid Income Limits for Seniors in Pennsylvania
|Income Limits*||Asset Limits|
(Only One Person Applying)
|$24,353||$2,000 for applicant|
$137,400 for non-applicant
(Both People Applying)
* Per year
Other requirements needed to apply for Medicaid include:
- US citizenship, permanent residency or documented alien status
- State residency
- Health care or medical insurance
- The financial situation must be classified as meager (see table below)
- Be disabled or live in a household with another individual who is disabled
Applying for Medicaid in Pennsylvania
Pennsylvania offers seniors several different ways to apply for Medicaid:
Online: Use the state government’s COMPASS website. You can apply for Medical Assistance (Medicaid) and other benefits available to residents of the state.
Telephone: Contact the Consumer Service Center For Healthcare Coverage at (866) 550-4355.
In-person: Visit your local County Assistance Office. You can obtain an application and receive help in filling it out.
Forms: Download an application and send it to your local County Assistance Office (CAO).
Before You Apply
When you apply for Medicaid, you’ll need to provide several essential documents:
- Proof of residency in the state
- Social Security number
- Proof of American citizenship, permanent residency or documented alien status
- Documents showing all income sources, including pay stubs if you’re working, Social Security or pensions
- Documents showing your assets, including retirement accounts, trusts and bank accounts
- The identification numbers for any commercial health care policies or your Medicaid number
Where to Go to Get Help
Senior residents of Pennsylvania who have questions about Medicaid or need help in applying have several resources available to assist them.
|Ombudsman Program||(717) 783-8975||While generally known for their duties as advocates for seniors in dispute with long-term care facilities, members of the state’s ombudsman program can also act as impartial third parties to provide advice to seniors who have been denied Medicaid or claims for prescription drug coverage. Ombudsmen can help seniors review any denials and reapply.|
|Information Retrieval Tool||(800) 753-8827||The Information Retrieval Tool helps seniors, or their caregivers, identify long-term care services and supports based on their specific needs. Seniors who have questions or require assistance can also call the PA Link Call Center at 1-(800)-753-8827.|
|Pennsylvania Health Law Project||(800) 274-3258||Pennsylvanian seniors who require assistance to resolve problems with Medicaid, such as denial of services or services being reduced, can contact the Pennsylvania Health Law Project’s hotline, which can help resolve issues. Project staff members can represent seniors in the appeals process.|
Can You Use Medicare to Pay for Assisted Living in Pennsylvania?
Unfortunately, Medicare does not cover the cost of assisted living in Pennsylvania. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.
For more information about Medicare, visit medicare.gov.
Are There Other Financial Assistance Options for Assisted Living in Pennsylvania?
|How to Apply||How It Works|
|Aid and Attendance||Apply online at va.gov.||If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.|
|Reverse Mortgages||Research and learn about the different types at ftc.gov||If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.|
|Long-Term Care (LTC) Insurance||Learn about how to receive LTC insurance benefits at acl.gov.||While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.|
Free and Low-Cost Resources for Seniors in Pennsylvania
Seniors in Pennsylvania have access to several free or low-cost resources. These resources include information or assistance on Medicare issues, free legal help, financial assistance with prescription drug plans and access to other resources in their communities.
|Office for Veterans Affairs||(215) 381-3040||Pennsylvania’s Office for Veterans Affairs offers assisted living in six veterans’ homes throughout the state for senior veterans, their spouses, or survivors. Senior veterans and their spouses live in a community setting and receive help with personal needs, ADLs and nursing care. Financial assistance is also available for veterans with low or very low incomes.|
|Area Agencies on Aging||(717) 783-1550||Area Agencies on Aging (AAA) flourish in the Keystone state. Fifty-two offices provide services and resources for seniors. AAA offices work with local organizations to provide these services and create new ones when they discover gaps in coverage. AAA offices work with seniors aged 60 and older. Some of the services they provide include tax assistance, information on assisted living facilities in Pennsylvania, legal help and counseling on Medicaid or Medicare issues.|
|Pace Prescription Assistance Program||(800) 225-7223||PACE and PACENET offer low-cost prescription drug assistance for seniors in Pennsylvania who are aged 65 and up and meet financial requirements. Your previous year’s income determines these financial requirements. Seniors must also be residents of the state for at least 90 days before making an application. For the Pace program, a single applicant’s income cannot exceed $14,500. The combined income of a married couple must be $17,700 or less. Income limits are higher for PACENET. An individual’s income cannot exceed $33,500 a year, while a married couple’s income cannot exceed $41,500. Both programs work with Medicaid Part D plans, retiree/union coverage, employer plans and veterans’ benefits.|
|Office of the State Long-Term Care (LTC) Ombudsman||(717) 783-8975||LTC ombudsmen advocates for seniors in conflict with long-term care facilities. They investigate complaints of abuse and neglect made by seniors or caregivers. When they complete their investigations, they work with both parties to resolve the issue. Ombudsmen can also provide impartial third-party advice to seniors on billing disputes, applying for Medicaid or Medicare, appealing negative Medicare or Medicaid decisions and providing information on resources for seniors in their communities. They also regularly hold workshops for the larger community about the rights of seniors in LTC facilities.|
|SeniorLAW Center||(877) 727-7529||The SeniorLAW Center provides Pennsylvanians with assistance on issues and problems concerning civil law matters. While the center can provide direct representation in some cases, it primarily offers legal guidance in these matters. It helps with housing problems, powers of attorney, wills, abuse or exploitation of seniors, advanced medical directives and consumer issues. The center cannot participate in any situation concerning a criminal matter, divorce issues or lawsuits.|
|Medical Assistance and Payment of Long-Term Care Services||(800) 692-7462||Low-income seniors requiring financial assistance to pay for some of the costs associated with assisted living may be eligible for the Medical Advance and Payment of Long-Term Care Services program. The program’s goal is to help seniors remain in their homes or communities. It provides health care benefits, long-term care support and financial assistance. Seniors or their caregivers can check to see if they are eligible for the program at the state government’s COMPASS website.|
COVID-19 Rules for Assisted Living in Pennsylvania
The following information is based on research done on several government websites, including dhs.pa.gov and cms.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/13/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Visiting Loved Ones
|Can I visit my relative in person if he/she wants emotional support from me?||Yes (Conditions Apply)|
|Can I visit my relative in person for end-of-life compassion care?||Yes|
|Will my loved one be required to self-quarantine after I visit him or her?||No|
|Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?||Yes|
|Are Hairdressers and other non-medical contractors still allowed in senior living facilities?||Yes|
|Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?||Yes|
|Are visitors being screened for elevated temperatures?||Yes|
|Are visitors being asked questions about health, travel, and potential virus contact?||Yes|
Outings and Group Activities
|Are residents allowed to leave the facility for non-medical reasons?||Yes|
|Are residents of senior living facilities who leave and return required to self-quarantine?||No (Conditions Apply)|
|Are senior living facilities required to cancel all group outings?||No|
|Are residents still eating together in the dining hall?||Yes (Conditions Apply)|
|Are facilities still allowed to host group activities within the community?||Yes (Conditions Apply)|
Safety Measures for Staff & Contractors
|Are staff members and contractors being screened for elevated temperatures?||Yes|
|Are staff members and contractors being tested for Coronavirus?||Yes (Conditions Apply)|
|Are staff members and contractors being asked questions about health, travel, and potential virus contact?||Yes|
Safety Measures for Residents
|Are staff members required to regularly screen residents for coronavirus symptoms?||Yes|
|Are residents relied on to screen themselves and self-report potential coronavirus symptoms?||No|
|Are staff members required to take residents’ temperatures?||Yes|
|Are residents being tested for coronavirus?||Yes (Conditions Apply)|
Assisted Living Laws and Regulations in Pennsylvania
Pennsylvania’s Department of Human Services, Bureau of Human Services Licensing oversees the laws and regulations concerning assisted living residences, including all ALRs and PCHs. The state government conducts regular inspections to ensure that facilities follow these regulations. Their goal is to ensure that all seniors live in safe facilities that provide them with the regulated necessities.