Pennsylvania Medicaid

A rapidly aging loved one can be the cause of much stress and anxiety in our otherwise under control existences. Aside from the decisions as to what type of care to pursue and where, there is always the question of funding. Assisted living and skilled nursing facilities are exorbitantly priced, and the cost is very often beyond the means average family, even those living the American dream.

Fortunately, there are options, and Pennsylvania Medicaid is a safety net that close to 60 million Americans rely on. Unfortunately, the PA Medicaid application process is as confounding as it is elongated, and many Medicaid Pennsylvania applicants and their families get lost trying to navigate Medicaid’s mirage of guidelines.

We at Senior Planning Services are in the business of assisting senior’s and their families with the Pennsylvania Medicaid application and eligibility process to achieve maximized benefits. Our service is a comprehensive one, and when we take on a client, a personalized case manager will assist in every aspect of the Medicaid application from the initial consultation, through the final approval.
Need help applying for Pennsylvania Medicaid? We can help!
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Understanding PA Medicaid

Medicaid is a federal and state funded program for individuals requiring health care. A large portion of Medicaid funds the health care of children and pregnant women while the remaining portion covers the care of the elderly and disabled. While the federal government foots a sizable part of the budget, each state will foot the remaining 40% of the bill and will instate individual state guidelines as to eligibility and coverage. Quaker state citizens can expect excellent PA Medicaid coverage as they navigate the many long-term care options available to them.

Financial Requirements

Once an individual is on PA Medicaid, his/her income goes to the facility and Medicaid will cover the difference in their nursing home coverage. Income includes Social Security, pension and any monies that are coming in on a monthly basis. When an individual is staying long term in a facility, there are some deductions that may come out of a Medicaid Applicant’s income:
  • A personal needs allowance (PNA) $45 in a Nursing Home that the Medicaid recipient can choose to use for whatever he/she wishes.
  • A supplemental health insurance premium to allow the policy to remain active.
  • Depending on the Scenario, the community spouse or a dependent child may retain some or all of the applicants income
As of 2024, in PA, if one earns $2,829 per month, they are allowed to keep up to $2,400 in resources. However, if your income is below $2,829 per month, you are allowed to keep up to $8,000.
Medical Eligibility
Medical Eligibility
As far as medical status is concerned, Medicaid will want to verify an applicants’ medical need. They will require forms to be filled out by the applicants’ physician and family members. A nurse from the Department of Health may also come down to do some clinical testing in some cases.

What Senior Planning Can Do

We at Senior Planning services are thoroughly familiar with the many rules and regulations governing Medicaid in each of the states we service and the ever-changing eligibility and coverage criteria. Many times a small mistake in the process will result in untold anguish and months of costly care not covered that could have been avoided with the proper knowledge and planning. Below are just a few of the processes one should be familiar with in order to win the eligibility game:
  • ‘Countable’ and ‘Excludable’ Assets
  • ‘Spend Down’
  • 5 Year ‘Look Back’
  • Irrevocable Prepaid Funeral Trust
  • ‘Community Spouse’ Laws
  • Transfers and Gifts
In addition to our comprehensive knowledge in our field of Pennsylvania Medicaid services, we pride ourselves in our customer service. As a PA Medicaid client, you will be treated as family and can expect one of our qualified case managers to hold your hand during the entire Medicaid PA application process from start to finish. This will include assisting you in obtaining documentation for the prior 60 months, constant contact with your case manager at the County Assistance Office, frequent updates on your eligibility status and a listening ear to your specific needs. We will not rest until your Pennsylvania Medicaid eligibility has been secured.

Our Medicaid Planning Services

  • Offer a free Medicaid Consultation
  • Assist in obtaining 60 months of bank and financial statements from financial institutions back offices.
  • Assist in obtaining verifications from banks regarding checks, deposits, and cash withdrawals
  • Guide families through the spend-down process
  • Assist families in utilizing excludable resources
  • Assist clients in the process of liquidating life insurance policies, annuities and stocks etc.
  • Obtain missing documentation from Vital Statistics, if necessary
  • Update client on status on a constant basis
  • Interact with the (CAO) County Assistance Office caseworker regularly
  • Submit application to the (CAO) County Assistance Office
The experts at Senior Planning Services are just a phone consultation away.
Let us replace your stress and anxiety with direction and clarity.
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