Long-term care • Pennsylvania
Pennsylvania Long-Term Care Insurance: Costs, Community HealthChoices, and Partnership Policies
Pennsylvania has one of the country’s oldest populations, and care is costly: a private nursing home room had a 2025 median of $164,250 a year, and assisted living $77,760. Medicare won’t pay for most long-term care. Pennsylvania’s Medicaid long-term care program, Community HealthChoices, helps once savings run low, and partnership policies can protect assets.
This guide covers Pennsylvania care costs, Medicaid long-term care, partnership policies, and coverage options.
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What care costs in Pennsylvania
| Type of care | Pennsylvania median |
|---|---|
| Assisted living community | $77,760 |
| Nursing home, semi-private room | $143,445 |
| Nursing home, private room | $164,250 |
Source: CareScout Cost of Care Survey, July–November 2025. The national median for assisted living was $76,200. Costs vary within the state, often running higher in large metro areas.
Medicaid long-term care in Pennsylvania
Pennsylvania provides Medicaid long-term services and supports, including nursing home care and home and community-based services, mainly through its managed care program, Community HealthChoices. You must meet income, asset, and care-need rules, and transfers made in the five years before you apply are reviewed. An elder law attorney can explain current Pennsylvania limits and estate recovery rules.
Estate recovery
After a Medicaid recipient age 55 or older dies, states must seek repayment from the estate for long-term care costs Medicaid paid, with exceptions such as a surviving spouse or a child under 21 or with a disability. That can affect a home you hoped to leave to family. Partnership policies can help protect assets from Medicaid estate recovery in many states; ask an elder law attorney how Pennsylvania applies it.
Partnership policies in Pennsylvania
Pennsylvania offers partnership-qualified long-term care policies. They protect assets from Medicaid spend-down equal to the benefits the policy paid, and they must include inflation protection that meets age-based rules. See how partnership programs work.
What Medicare won’t pay
Medicare doesn’t cover long-term custodial care, the everyday help with bathing, dressing, and eating that most people need (Medicare.gov). It can cover a skilled nursing facility stay of up to 100 days after a qualifying hospital stay, but in 2026 you pay $217 a day for days 21 through 100 (CMS). For longer care, Pennsylvania residents rely on savings, insurance, or Medicaid.
Protections for a spouse at home
Federal rules protect part of a married couple’s assets and income when one spouse needs Medicaid long-term care. For 2026, states protect between $32,532 and $162,660 in assets for the spouse at home, with a monthly income allowance of at least $2,643.75 and up to $4,066.50 (CMS). Each state chooses where within those ranges to set its limits.
Coverage options for Pennsylvania residents
- Traditional long-term care insurance: the most care benefit per premium dollar, though premiums can rise.
- Hybrid life and LTC policies: care benefits plus a death benefit if you don’t need care.
- Life insurance riders: use part of a death benefit for care.
- Short-term care insurance: covers a year or less of care, with simpler underwriting.
Premiums for tax-qualified policies can be deductible as medical expenses, up to $4,960 for ages 61 to 70 and $6,200 for 71 and older in 2026 (ElderLawAnswers).
Example: two years in a Pennsylvania nursing home
Illustrative only: two years in a private Pennsylvania nursing home room at the 2025 median would cost about $328,500. A partnership policy paying $200,000 in benefits would cover part of that and, if you later applied for Medicaid, protect $200,000 of assets beyond the normal limit.
Checklist for Pennsylvania residents
- Estimate care costs in your area; Philadelphia-area costs are usually higher.
- Decide how much you could pay from savings.
- Ask whether a policy is partnership-qualified and meets inflation rules.
- Talk with an elder law attorney about Medicaid and estate recovery.
- Compare options while you’re healthy.
Pennsylvania long-term care FAQs
How much does a nursing home cost in Pennsylvania?
The 2025 median for a private room was $164,250 a year, according to CareScout.
How much does assisted living cost in Pennsylvania?
The 2025 median was $77,760 a year.
Does Medicare pay for long-term care in Pennsylvania?
No. Medicare doesn’t cover long-term custodial care, though it can cover short skilled nursing stays.
What is Community HealthChoices?
Pennsylvania’s managed care program for Medicaid long-term services and supports.
Does Pennsylvania have a long-term care partnership program?
Yes. Partnership-qualified policies are available.
What is the Medicaid look-back in Pennsylvania?
Transfers made in the five years before applying are reviewed.
Does a partnership policy protect my home?
Your home is treated under Medicaid’s home rules; partnership protection applies to countable assets equal to benefits paid.
Can Pennsylvania Medicaid take my house after I die?
Estate recovery may seek repayment from your estate, with exceptions for a surviving spouse and certain children; ask an elder law attorney.
Related guides
Important information
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Cost and program figures. Care costs, Medicare and Medicaid amounts, and tax limits are cited from the sources named, for the years shown, and change regularly. Examples are illustrative, not quotes; your price depends on the insurer, your age, health, and the coverage you choose.
Not tax, legal, or Medicaid planning advice. Rules summarized here are general information as of November 2026. Talk with a tax professional or elder law attorney about your situation.
Availability. Coverage, prices, discounts, and eligibility vary by insurer, state, and applicant, and are subject to underwriting. The issued policy controls.
Your next step
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