How does the medically needy pathway work in Pennsylvania?
Short answer: In Pennsylvania, a nursing home applicant whose income is above $2,982 a month can still qualify as medically needy if their income is not enough to pay the nursing home’s cost.
Figures change periodically. Double-check current amounts before relying on them.
Pennsylvania does not require a Miller trust for nursing home care. Instead, a nursing home applicant whose income is above the special income limit ($2,982 a month in 2026) can qualify through the medically needy route, as long as their income is less than the cost of their nursing home care. The resident pays their income toward the cost of care (minus the personal needs allowance and other allowed deductions), and Medical Assistance pays the rest.
The asset limit is different for the two routes. According to our Pennsylvania guide, a single applicant under the special income limit can keep $2,000, plus a $6,000 disregard (about $8,000 in total), while the medically needy route uses a $2,400 limit.
Home and community-based services follow different rules, and the medically needy route generally does not apply to waiver services in the same way. Our state guide explains the 2026 figures and the application process, including the state’s online and phone options.
Because the asset limit depends on which route applies, it is worth working out the route before spending down.
Getting help
Every situation is different, and small facts can change the answer. If this question affects a real decision, especially with a spouse at home, a home, gifts or a trust, a Certified Medicaid Planner can apply your state’s rules to your situation. As a rough guide, published fees for help with an application range from about $500 to $6,000, and hourly help from about $150 to $600.
Related
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.