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How does Medicaid eligibility work in Pennsylvania?

On Behalf of | Mar 31, 2020 | Medicaid and Medical Assistance | 0 comments

As your parents age, you may wonder how your family will afford the long-term care they need. In Pennsylvania, the Medicaid Medical Assistance program offers long-term care coverage, including nursing home and assisted living care, for qualifying adults ages 65 and older.

Learn more about whether your older loved ones are eligible for senior medical coverage through Medicaid.

Income limits

Seniors in Pennsylvania must fall under a specific income and assets threshold to qualify for Medicaid’s institutional long-term care program. The 2020 income limits are as follows:

  • $2,349 a month for a single individual
  • $2,349 a month for a single individual applying without his or her spouse
  • $4,698 a month for married spouses applying together

Medicaid considers stock dividends, investment and retirement plan withdrawals, pension payments, Social Security benefits, alimony and earned wages to be income.

Asset limits

Pennsylvania has also established asset limits for seniors. These limits cover checking accounts, savings accounts, investment accounts, bonds and stocks. Exempt assets include up to $595,000 in equity in the person’s primary residence, irrevocable burial trusts, household items such as furniture and personal belongings.

Although the asset limit is $2,000 per individual, the state has provided for an additional exemption of $6,000. This brings the total asset limit to $8,000 for individuals who also fall under the income limits. Individuals who exceed the income limits are subject to a $2,400 asset limit.

Medically needy applicants

This category provides a pathway to Medicaid for seniors who do not meet the income and asset qualifications. Under this program, any income that exceeds the limits will cover the person’s medical bills for the first six months of the year. This “spend-down” program then qualifies the person for Medicaid for the second half of the year.

Federal and state Medicaid laws are complex and subject to annual updates. Careful planning can help your family prepare for its oldest members’ long-term care needs.