Paying for nursing home care can be overwhelming. In Pennsylvania, the average cost of a nursing home can exceed $10,000 per month. Because these costs are so high, many families eventually turn to Medicaid for help.
Understanding how Medicaid eligibility works can help families plan ahead and avoid costly mistakes.
Medicaid Eligibility Basics
Medicaid is a joint federal and state program that helps cover long-term care costs for individuals who meet certain financial and medical requirements.
To qualify for Medicaid nursing home benefits in Pennsylvania, an individual generally must:
- Require a nursing home level of care
- Meet income limits
- Meet asset limits
Asset Limits
Medicaid limits the amount of countable assets a person can have. Countable assets may include:
- Bank accounts
- Investment accounts
- Additional real estate
- Certain retirement funds
Some assets are usually exempt, including:
- A primary residence (within equity limits)
- Personal belongings
- One vehicle
- Certain prepaid burial arrangements
Income Rules
Applicants must also meet income requirements. Income such as Social Security, pensions, or retirement distributions is considered when determining eligibility.
If the applicant’s income exceeds certain limits, planning strategies may still be available to help qualify.
The Importance of Planning
Many families assume they must spend all their savings before qualifying for Medicaid. In reality, careful planning may allow individuals to preserve assets while still receiving needed care.
Because Medicaid rules are complex, consulting with an experienced attorney can help families understand their options and avoid costly mistakes.
