Pennsylvania Home Care Medicaid

Last updated: August 21, 2026 Jurisdiction: Pennsylvania

CHC supports care in the community

Community HealthChoices delivers home- and community-based services to participants who need nursing-facility level of care but choose to remain in the community. PA DHS, Apply for Community HealthChoices DHS lists personal assistance, home modifications, personal emergency response systems, respite, residential habilitation, community integration, adult daily living services, and participant-directed goods and services. PA DHS, Apply for Community HealthChoices

CHC is delivered through three statewide managed-care organizations. PA DHS, CHC Providers Read the companion Pennsylvania Medicaid long-term-care page for CHC's overall structure.

What the program data show

A PA Health & Wellness provider summary reports 150,504 CHC participants needing LTSS and describes the LTSS group as split between nursing-facility and home/community waiver participants. PA Health & Wellness, CHC population summary The same summary places roughly 64.2% of that LTSS group in home/community waiver programs, an approximate breakout rather than a personal entitlement estimate. PA Health & Wellness, CHC population summary

Separate route for older adults: the state-funded OPTIONS program has no income-eligibility requirement but uses a sliding-scale co-payment and is not an entitlement. PA Department of Aging, OPTIONS Program

OPTIONS is not Medicaid LTSS

OPTIONS is administered by the Pennsylvania Department of Aging through 52 local Area Agencies on Aging for qualifying residents age 60 or older who meet the stated residency, citizenship or lawful-permanent-residence, frailty, and unmet-need conditions. PA Department of Aging, OPTIONS Program

People already receiving Medicaid LTSS, LIFE, HCBS waiver services, or Act 150, and people residing in listed institutional or residential settings, are not eligible for OPTIONS. PA DHS, OPTIONS Program overview The policy manual lists a $765 average monthly cost cap over a 12-month care-plan period, subject to specified exclusions. PA Department of Aging, OPTIONS policy manual

Financial rules still apply to CHC

CHC home-care access does not eliminate MA's income, resource, and level-of-care requirements. PA DHS, Medicaid Payment for Long-Term Care For a different state model, see Florida's home-care Medicaid page and the Medicaid (Baseline) pillar.

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CHC supports care in the community

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