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Medicaid Information

Key Medicaid Information for
Pennsylvania

Note: Institutionalized Medicaid recipients in Pennsylvania with monthly income below $2,199 may now retain $8,000 in total resources; otherwise, the figure is $2,000.

*Note on annuities: "There is split authority on the effect of a purchase of an actuarially sound annuity in Pennsylvania. A state appeals court has held that the purchase of an actuarially sound annuity by a community spouse may result in a transfer penalty. A federal district court has held exactly the opposite. The state Medicaid agency's office of legal counsel reviews all annuity purchases that fall within the lookback period. It is not clear what criteria they are using in their evaluation - it appears to be subjective." --Marshall

Protections for the Community Spouse

Community Spouse Resource Allowance (CSRA):: Minimum: $27,480
Maximum: $137,400
Increased CSRA:: Permitted. Pennsylavania does not follow the income-first rule.
Annuities:: See note above*
Monthly Maintenance Needs Allowance:: Minimum: $2,177.50
Maximum: $3,435

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Medicaid Protections for the Healthy Spouse

Transfers

Figure used to calculate transfer penalties:: $11,099.04 ($364.90 per day)
Has a Long-Term Care Partnership program been implemented?: Yes

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Assets

Are IRAs and other retirement plans protected (noncountable)?: No
State's resource limit for Medicaid recipients:: $2,400

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Income

Is the state an "income cap" state?: No
Monthly personal needs allowance for nursing home residents:: $45

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Estate Recovery

Has the state expanded the definition of "estate" beyond the probate estate?: Yes
Has the state included a hardship provision in its estate recovery plan?: Yes

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Medicaid's Power to Recoup Benefits Paid: Estate Recovery and Liens

Home Equity Limit

The state Medicaid program will not cover long-term care services for those with home equity above this limit, with certain exceptions.: $636,000

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