Pennsylvania Department of Aging Medicaid Waiver
What are Medicaid Waivers?
Medicaid pays for long term care services in nursing homes. For nursing home qualified persons that choose to live at home or in a residential community, Medicaid will pay for those services if they can be obtained at a lower cost. These are called Home and Community Based Services, Waiver Funded Services, Medicaid Waivers or simply Waivers.
PDA Waiver Overview
This Medicaid Waiver provides home and community based services to seniors who require nursing facility care but elect to live in their own homes or in other community living arrangements and receive care in those locations. It is also referred to as the PA Council of Aging Waiver, the PDA Waiver or the Home and Community-Based Waiver for Individuals Aged 60 and Over.
Under this waiver, certain goods, supports and services can be participant directed or self-directed. This means the individual chooses from whom they purchase goods or care services. Pennsylvania also has a more robust program which allows the individual even greater control of their care providers called the Services My Way Program
Aging Waiver Eligibility Guidelines
In addition to living in PA, residents must be at least 60 years old and require the level of care typically provided in a nursing home. They also must qualify financially for Medicaid in Pennsylvania, which is sometimes called "Medical Assistance" or abbreviated MA.PA Medicaid Eligibility Requirements for 2013
The income limit for an individual applying for Medicaid is $2,130 / month. If one spouse is applying for Medicaid and the other is not, joint income can be shifted to help the applicant qualify.
The asset limit for the PDA waiver is $8,000. Resources in excess of that amount will need to be spent down or re-allocated into exempt (non-countable) assets. In the situation previously described, where one spouse of a married couple is applying, resources in excess of $8,000, up to a maximum of $115,920 can be allocated to the non-applicant spouse. This is referred to as the Community Spouse Resource Allowance.Applicants Exceeding these Limits
PA has a Medically Needy Medicaid program that enables residents with unusually high care costs to qualify for the program. Alternatively, Medicaid planning professionals can work with a family to arrange their assets and income into annuities and trusts so that they meet the eligibility requirements. For example, by pre-funding a funeral using an irrevocable funeral trust
, one can reduce their countable assets by up to $15,000. Persons in this situation should find Medicaid planning help
Services / Benefits
The services provided under this waiver are determined on a needs basis. Individuals can be approved for any of the following:
-Adult Daily Living Services (Adult Day Care)
-Attendant Care (Personal Care)
-Community Transition Services (Moving Assistance)
-Companion Services (Escort)
-Environmental Accessibility Modifications (Home and / or Vehicle)
-Financial Management Services
-Home Health Services
-Home Medical Equipment and Supplies
-Meal Delivery (Hot or Prepared)
-Personal Emergency Response (PER) System
-Respite Care Services (Temporary Caregiver Relief)
How to Apply / Program Availability
Use our Locator Tool to Find Other Options for which You're EligiblePage Reviewed / Updated - Feb. 2013
While previously only available in certain areas of the state, the PDA Waiver is now available statewide in all 67 counties. However, this waiver is not an entitlement. This means that even though one meets all the eligibility requirements, it does not necessary mean they will immediately be able to receive services. It is very likely that waiting lists exist for services.
One can learn more about the program on the following website
. To apply individuals should contact their local County Assistance Office