Pennsylvania Long-Term Care Planning

Last updated: August 21, 2026 Jurisdiction: Pennsylvania

Plan around the rules actually in force

Pennsylvania's MA long-term-care analysis starts with income, resources, level of care, and a five-year review of below-market transfers. PA DHS, Medicaid Payment for Long-Term Care DHS describes both a $2,982 300%-FBR pathway and a medically needy spend-down path, so Pennsylvania should not be treated as a universal hard-income-cap state. PA DHS, Medicaid Payment for Long-Term Care

The state also has spousal resource and income protections, with 2026 federal standards listing a $32,532 to $162,660 CSRA and a $2,705.00 MMMNA floor for the applicable period. HHS/CMS 2026 Standards

Trusts and deeds require Pennsylvania-specific advice

Secondary elder-law sources describe properly drafted irrevocable Medicaid Asset Protection Trusts as subject to the same 60-month review and emphasize that the grantor cannot retain access to principal if the asset is to become non-countable. Keystone Elder Law, MAPT FAQ That is commentary, not a DHS trust rule quoted here, so a proposed trust should be reviewed individually. Lebovitz Law, Pennsylvania Medicaid Planning

Do not plan as if Pennsylvania has a TOD or Lady Bird deed: the Commonwealth has no current real-property TOD deed and no Florida-style enhanced life estate deed. The Trusted Advisor, Pennsylvania estate-planning overview

Read Pennsylvania's life-estate-deed page and compare Florida's planning page before importing another state's deed or income-trust assumption.

Filial responsibility is a genuine Pennsylvania issue

23 Pa.C.S. § 4603 imposes a duty on the spouse, child, and parent of an indigent person to care for, maintain, or financially assist that person, subject to stated financial-ability and parental-abandonment exceptions. Pennsylvania General Assembly, 23 Pa.C.S. § 4603

In Health Care & Retirement Corp. of America v. Pittas, the Pennsylvania Superior Court upheld a $93,943.41 nursing-home judgment against John Pittas and held that the provider did not have to first exhaust his mother's Medicaid application or other payment sources. Justia, Pittas opinion

Reform proposals are not current law

HB 65 and SB 630 were still pending in the 2025–2026 session in the research for this page, rather than enacted reforms to the filial-support law. Pennsylvania General Assembly, HB 65 Pennsylvania General Assembly, SB 630 Planning should account for the live statute and consult the Advance Medicaid Planning pillar plus Pennsylvania counsel for a family-specific assessment.

Not mutually exclusive. Most families combine two or three funding pillars — this one rarely stands alone. The Journey Assessment ranks all ten pillars against your specific situation and recommends the top three.

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Pennsylvania Long-Term Care Planning

Plan around the rules actually in force

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