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In Pennsylvania, in-home care and home health care both cost an average of $4,957 per month, according to the 2021 Genworth Cost of Care Survey. The two terms sound similar, but they’re different services. In-home care offers personal care assistance and homemaker services, including meal preparation, light housekeeping and help with daily living activities. In contrast, home health care refers to the services provided by licensed professionals, such as nurses, physical therapists, occupational therapists and medical social workers.
Maryland, New Jersey and New York have higher average monthly home care costs than Pennsylvania. Both care types are $5,148 per month in Maryland. New Jersey’s monthly in-home care cost is $5,529 and home health care is $5,710, while New York’s costs are $5,339 for in-home care and $5,529 for home health care. Ohio has the same average costs of in-home care as Pennsylvania, but it’s slightly more expensive for home health care, with an average monthly cost of $5,053. Pennsylvania’s cost of in-home care is right in line with the national average, but it comes in slightly below the national average for home health care, which is $5,148 per month.
|Home Care||Home Health Care|
Pennsylvania seniors have several community-based and residential care options. Nursing home care is the most expensive, averaging $10,403 per month. Assisted living costs an average of $4,100 per month, making it more expensive than home care, while adult day care is the most affordable option at $1,625 per month.
Pennsylvania’s Medicaid program, known as Medical Assistance, covers home care as part of its long-term services and supports. Participants must demonstrate a medical need to receive long-term care in their homes instead of in nursing homes or other institutional settings. Depending on the participant’s needs, Medicaid may cover companion care, behavioral services, medical transportation, services coordination and other types of home care.
Waivers help Medicaid enrollees by giving them access to services that Medicaid may not cover under its traditional guidelines. Depending on the terms of the program, a waiver may cover additional services or allow participants to self-direct their care. Pennsylvania has two waiver programs to help seniors pay for home care with their Medicaid benefits.
Living Independence for the Elderly (LIFE)
The Living Independence for the Elderly (LIFE) waiver gives eligible participants access to home-based services, including personal care, social services and meals. Applicants must be at least 55 years old and require a nursing facility care level. Each applicant must also demonstrate that they can live safely at home if they receive additional services and supports. Call (877) 998-5433 to inquire about transitioning to the LIFE program.
Community HealthChoices is open to adults who are at least 21 years old and are physically disabled. Each applicant must also require a nursing facility care level. The program pays for daily living services, home-delivered meals, transportation services, assistive technology and more. The easiest way to apply is to use the PA COMPASS website, but you can also visit a local county assistance office or call (866) 550-4355.
To qualify for traditional Medicaid, an applicant must meet specific requirements related to their income and assets. As of 2022, the annual income limit for a single applicant is $10,357.20. For a two-person household, the annual income limit is $15,531.60. The asset limit, which typically excludes an applicant’s primary residence, is $2,000 for individuals and $3,000 for married couples.
|Income Limits*||Asset Limits|
Pennsylvania also has nonfinancial eligibility requirements for Medicaid. To qualify, you must reside in Pennsylvania, need health insurance assistance and be a U.S. citizen, legal alien, permanent resident or U.S. national.
Pennsylvania offers the following options for residents interested in applying for Medical Assistance:
What Information You Will Need
When applying for Medicaid, you’ll need supporting documents to verify your eligibility. These include:
How to Get Help Applying for Medicaid in Pennsylvania
Seniors who need help applying for Medicaid should consult one of the organizations below. Each resource has trained staff or volunteers available to answer questions and solve Medicaid-related problems.
|Contact||Area Served||Services Provided|
|Pennsylvania Department of Human Services||Contact your county office||Entire State||The Pennsylvania Department of Human Services oversees a network of county assistance offices staffed by employees well-versed in the Medical Assistance eligibility requirements. Employees can answer questions and provide updates on the status of submitted applications.|
|Pennsylvania Health Law Project (PHLP)||(800) 274-3258||Entire State||PHLP offers free legal advice to Pennsylvania residents dealing with a variety of Medicaid problems. Seniors can call the helpline if they’re denied Medical Assistance or have questions about why it reduced or eliminated their services.|
|COMPASS||Online||Entire State||COMPASS connects Pennsylvania residents with Medical Assistance and other public health benefits. Creating an account makes it easy to submit an application and track its status from the convenience of your home. COMPASS also has a mobile app, giving users 24/7 access to benefits information.|
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.
While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.
Pennsylvania has many resources to help seniors pay their bills and maintain their health for as long as possible. Contact the organizations below if you need extra support to age in place.
|Contact||Area Served||Services Provided|
|Low-Income Home Energy Assistance Program (LIHEAP)||(866) 857-7095||Entire State||LIHEAP provides cash grants to help eligible Pennsylvania residents pay their heating bills. The amount of assistance available depends on the applicant’s household size and income. LIHEAP also provides crisis grants to help consumers deal with energy emergencies. Recipients can use crisis grants to prevent utility shutoffs, restore service after a shutoff or address energy-related safety issues.|
|Water Assistance Program||(877) 395-8930||Entire State||Pennsylvania’s Water Assistance Program helps low-income consumers pay their overdue water bills. Crisis grants are also available to assist consumers in danger of losing their drinking water or wastewater services.|
|Pennsylvania Department of Aging Meals||(717) 783-1550||Entire State||The Pennsylvania Department of Aging provides meals to more than 500 senior community centers throughout the state. Meals are available to Pennsylvania residents at least 60 years old and their spouses. The Pennsylvania Department of Aging also provides home-delivered meals to eligible seniors.|
|Help at Home||Contact your local Area Agency on Aging||Entire State||Help at Home offers services and supports to Pennsylvania residents who are at least 60 years old and have unmet needs that affect their daily functioning. The core program includes in-home meals, adult day services, personal care services and care management.|
|Free Transit Program for Senior Citizens||Contact your local public transit agency||Entire State||The Free Transit Program for Senior Citizens allows adults 65 and older to ride local transit systems for free during normal operating hours. Service routes and schedules vary based on location. To qualify for free rides, each passenger must obtain a free senior citizen transit identification card.|
Pennsylvania’s home health agencies must follow the Centers for Medicare & Medicaid Services (CMS) Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule, issued early 2022. According to this rule, all home health agencies receiving Medicare or Medicaid funds must require full COVID-19 vaccination of their staff members by February 28, 2022.
The CMS guidelines are current as of April 2022, but government officials are monitoring the pandemic closely and may create new rules at any time. To learn more about the current regulations, contact a local Area Agency on Aging. Even if a home care provider isn’t required to follow the CMS rule, they may set requirements related to vaccination and/or the use of masks, shields and other personal protective equipment. Contact your agency to learn more about the rules in your area.
|What Types of Care Can Be Provided?||Home care aides may take vital signs, observe clients to determine if they need medical care and assist clients with ambulation and personal hygiene. A home care aide may also report their observations regarding a client’s behavior to the supervising nurse for further assessment.|
|Are Care Plans Required?||In Pennsylvania, a provider must write a care plan for each client. Care plans should include information about the client’s medical diagnosis, behavioral health needs, functional limitations and rehabilitation potential.|
|Can Home Care Providers Assist with Medication Management?||Home health aides can assist clients with self-administered medications.|
|Are There Special Requirements for Screening Home Care Aides?||The Department of Health does not have minimum screening standards for home health aides. Agencies may choose whether to conduct background checks or use additional screening tools.|
|Are Home Care Aides Required to Undergo Special Training?||Home health aides must receive training on the aging process, nutrition principles, infection control and other topics related to senior care. Licensed health professionals must meet the training requirements established by the appropriate licensing body, such as the Board of Nursing or the State Board of Social Workers.|
|Does Medicaid Cover Home Care in Pennsylvania?||Yes. Pennsylvania Medical Assistance covers home care directly, and there are two waiver programs that provide expanded access to home- and community-based services: Living Independence for the Elderly (LIFE) and Community HealthChoices. Both waivers cover personal care, help with daily living activities and other home-based services.|
|How Do I Report Abuse of Myself or a Loved One?||You can report suspected abuse of yourself or a loved one to the Pennsylvania Department of Aging at (800) 490-8505.|
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.