Paying for assisted living in Pennsylvania is rarely one check from one place. Most families start with the resident's income and savings, then add long-term care insurance, veterans benefits or Medicaid when those fit. CareScout's latest Pennsylvania cost release publishes statewide median costs that sit slightly above the national assisted living median, and prices still vary by metro area and care needs1.
This Pennsylvania guide explains how those pieces fit together, how personal care homes differ from licensed assisted living residences for payment, what Community HealthChoices (CHC) can and cannot cover, why OPTIONS is a home-care path rather than facility rent, and how to build a written payment plan. For the national overview, see how to pay for assisted living. For every care type, see paying for senior living.
What assisted living costs in Pennsylvania
CareScout's 2025 Cost of Care Survey publishes statewide median costs for Pennsylvania assisted living based on a private one-bedroom over twelve months. Pennsylvania's assisted living median sits slightly above the national median in that release, and CareScout notes that actual prices vary by metro area, services and the level of help needed1.
Treat any survey median as a planning number, not a quote. Ask each community for a written monthly price that separates the base rate from care-level charges, medicine management, incontinence care and one-time move-in costs. Our assisted living costs guide explains common pricing models.
Private funds: the first layer
In Pennsylvania, private money is almost always the starting point. The Department of Human Services states that personal care homes and assisted living residences are typically not covered by Medicaid and that payment rates are set by the facility. The vast majority of residents pay privately, though some also receive home- and community-based services2. Federal rules generally bar Medicaid from paying room and board in home- and community-based settings3.
- Income. Social Security, pensions and retirement-account withdrawals are the steadiest monthly base.
- Savings and investments. Bank accounts, IRAs and brokerage accounts often fund the gap between income and the monthly bill. Plan withdrawals with a tax adviser when retirement accounts are involved.
- Family contributions. Adult children sometimes share costs. Put the agreement in writing: who pays what, and what happens if the bill rises.
- Annuities and life insurance. Some families convert a life policy or use an annuity to create steadier monthly income. Get independent advice before you change a policy.
Most assisted living nationwide is paid privately4. Add up monthly income and assets, then divide by the all-in prices you collected. The month when funds would run thin is the month you want CHC, insurance or VA paperwork already underway.
Using the family home
- Selling. A sale often funds the move. Some or all of the gain may be excluded from income if IRS ownership and use tests are met7.
- Renting. Rental income can help cover the monthly bill while keeping the home.
- Bridge loans and reverse mortgages. Some families use short-term loans while a house sells. Reverse mortgages are generally designed for people who stay in the home, so get independent advice before borrowing4.
If a sale is part of the plan, our downsizing tips can help with the move itself. Keep Medicaid transfer rules in mind before you gift sale proceeds to relatives. For nursing home care, see Pennsylvania Medicaid nursing home eligibility.
Long-term care insurance
If your parent bought a long-term care policy years ago, dig out the paperwork even if you are unsure it is still active. Confirm three things: the daily or monthly benefit, the elimination period (the days you pay out of pocket before benefits start), and whether assisted living or a personal care home is a covered setting. Some older policies cover only nursing-home care89.
File the claim as soon as care begins, and ask the insurer exactly what starts the elimination-period clock. For a fuller walkthrough, see long-term care insurance. Pennsylvania SHIP counselors can also help with Medicare and insurance questions10.
Read moreLong-Term Care Insurance: What It Covers and How It Works
VA Aid and Attendance
Wartime veterans and surviving spouses who qualify for a VA pension may receive that pension at the higher Aid and Attendance rate when they need help with daily activities such as bathing, dressing or feeding1112. The cash benefit can go toward assisted living or a personal care home. VA does not pay assisted living rent directly as a facility payment, though VA health care may cover some related medical services13.
Aid and Attendance is not a second check stacked on the basic pension. It is a higher maximum annual pension rate. The VA pays the difference between countable income and that maximum, so a veteran with countable income receives less than the full ceiling11.
State veterans programs. The Pennsylvania Department of Military and Veterans Affairs operates six state veterans homes across the state. Ask each home directly which levels of care it offers and how admission works before you count it in your plan15. For Pennsylvania-specific veterans resources, see our Pennsylvania VA benefits page.
Our deeper guide is VA Aid and Attendance. Applications can take months, so start early if military service is part of your family's story.
Read moreVA Aid and Attendance: Who Qualifies and How to Apply
Personal care homes vs assisted living residences
Pennsylvania licenses two related residential settings that families often both call assisted living. A personal care home (PCH) provides shelter, meals, supervision and help with personal care for adults who cannot live safely at home but do not need twenty-four hour nursing facility care. An assisted living residence (ALR) offers the care a PCH provides and may serve people with higher needs who still do not require twenty-four hour nursing care, with more opportunity to age in place2.
PCHs follow 55 Pa. Code Chapter 2600. ALRs follow Chapter 2800. DHS inspects and licenses both216. Ask every community which license it holds and which payment sources it accepts before you compare monthly prices.
DHS's consumer page is clear that PCHs and ALRs are typically not covered by Medicaid and that rates are set by the facility. Some residents receive home- and community-based services while living there, but that is not the same as Medicaid paying the full monthly residence bill2.
Community HealthChoices and residential care
Medicare does not pay for assisted living rent or ongoing personal care17. Pennsylvania's main Medicaid long-term services path for many adults age 21 or older is Community HealthChoices (CHC), a managed care program that coordinates physical health and long-term services and supports for dual-eligible people and for people who receive Medicaid long-term supports18.
CHC enrollment can include people who receive both Medicare and Medicaid, people in certain former OLTL waivers (including the Aging waiver path), people in nursing facilities covered through Medicaid, and other groups listed by DHS. People who are not yet in CHC can start through the Independent Enrollment Broker1819.
Some PCH and ALR residents receive home- and community-based services while living there, but DHS still describes those settings as typically not covered by Medicaid for the residence bill itself2. Federal rules generally bar Medicaid from paying room and board in home- and community-based settings, so families should plan for that cost separately even when a CHC plan authorizes related supports3.
Separately, CHC managed care organizations may offer Department-approved In Lieu of Services (ILOS), including an Assisted Living ILOS option that can substitute a licensed assisted living setting for nursing facility care when the plan offers it and the participant qualifies and chooses it. ILOS must be approved by DHS; plans are not required to offer every ILOS; and participants cannot be required to use an ILOS instead of a covered state plan service202122.
- Ask the plan. If your parent is already in CHC, ask the plan whether Assisted Living ILOS or waiver supports in a residential setting apply, which ALRs are contracted, and what the participant still pays toward room and board2120.
- Not yet in CHC. Contact the Independent Enrollment Broker to learn about CHC enrollment before assuming a facility can bill Medicaid for residence costs19.
- Nursing-facility Medicaid is different. Nursing facility care covered through Medicaid is an institutional path. CHC can also cover nursing facility services, but that is not the same as private-pay assisted living or a personal care home stay18.
For how Medicaid programs work across states, see Does Medicaid pay for assisted living?.
Read moreDoes Medicaid Pay for Assisted Living? How Waivers Work
OPTIONS helps people stay at home
You may also hear about the Department of Aging OPTIONS program. OPTIONS provides home- and community-based help for Pennsylvanians age 60 or older who want to stay in their homes, including personal care, adult day services, care management and home-delivered meals23.
OPTIONS is not a way to pay personal care home or assisted living residence costs. Department of Aging policy states that OPTIONS services may not be provided to people residing in personal care homes, assisted living residences or nursing homes24. Treat OPTIONS as a stay-at-home support path, not as facility rent.
While you sort residential payment options, your local Area Agency on Aging and the Eldercare Locator can still help with assessments, caregiver supports and other community resources2325.
What Medicare does and does not cover
Medicare does not pay assisted living rent or ongoing personal care such as help with bathing and dressing174. It still covers doctor visits, hospital care, skilled nursing facility stays that meet Medicare rules, home health when criteria are met, hospice and most outpatient prescriptions through Part D.
Do not count on Medicare to close the monthly assisted living gap. Build the payment plan from private funds, insurance, VA benefits and, when eligible, Community HealthChoices instead.
Build a Pennsylvania payment plan
- Get written prices. Ask two or three Pennsylvania communities for all-in monthly prices at the care level your parent needs now. Ask whether they are licensed as a PCH or ALR, whether they contract with any CHC plan, and what happens if private funds run out.
- List income, assets and benefits. Include Social Security, pensions, savings, insurance and any VA pension.
- Estimate how long private funds last. Factor in likely price increases and higher care levels over time.
- Call CHC or the Independent Enrollment Broker early if Medicaid may be needed. Ask about waiver supports, Assisted Living ILOS availability and contracted residences1921.
- Start VA or insurance claims early. Both can take months. Use a free VA-accredited representative for VA claims14.
- Get advice on complex finances. Your County Assistance Office, an elder law attorney, a financial planner or a SHIP counselor can help with trusts, look-backs and policy questions1025.
Ready to compare communities? Browse assisted living in Pennsylvania, take our care quiz, or use the assisted living tour checklist. Check licenses through the Human Services Provider Directory before you decide26.
